THERAPEUTICS 



AND 



MATERIA MEDICA. 



STILLE'S THERAPEUTIC S-lSTew Edition-Lately Issued. 

THERAPEUTICS AND MATERIA MEDICA : A Systematic Treatise 
on the Action and Uses of Medicinal Agents, including their De- 
scription and History. By Alfred Stille, M.D.. Professor of the 
Theory and Practice, and of Clinical Medicine, in the University of 
Pennsylvania, etc. Fourth edition, revised and enlarged. In two 
large and handsome octavo volumes of nearly 2000 pages : cloth, 
$10; leather, $12. 

It is unnecessary to do much more than to announce the appearance of the fourth 
edition of this well-known and excellent work. — Brit, and For. Med.-Chir. Biv., Oct. 
1875. 

We can hardly admit that it has a rival in the multitude of its citations and the 
fulness of its research into clinical histories, and we must assign it a p'ace in the 
physician's library ; not. indeed, as fully representing the present state of knowledge 
in pharmacodynamics, but as by far the most complete treatise upon the clinical and 
practical side of the question.— Bost. Med. and Surg Journ., Nov. 5, 1874. 

The magnificent work of Professor Stille is known wherever the English language 
is read, and the art of medicine cultivated: known so well that no encomiums of ours 
could brighten its fame, and no unfavorable criticism could tarnish its reputation. — 
Pltila. Med. Times, Dec. 12, 1874. 

The prominent feature of Dr. Stille's great work is sound good sense. It is learned, 
but its learning is of inferior value compared with the discriminating judgment which 
is shown by its author in the discussion of his subjects, and which renders it a trust- 
worthy guide in the sick-room. — Am. Practitioner, Jan. 1875. 



STILLE & MAISCH'S DISPENSATORY-Preparing for early Publication. 

THE NATIONAL DISPENSATORY. Embracing the Chemistry, Bot- 
any, Materia Medica, Pharmacy, Pharmacodynamics and Thera- 
peutics of the Pharmacopoeias of the United States and Great 
Britain. For the Use of Physicians and Pharmaceutists. By 
Alfred Stille, M.D., LL.D. , Prof, of Theory and Praotice and 
Clin. Med. in University of Pennsylvania, and John M. Maisoh, 
Ph.D., Prof, of Materia Medica and Botany in the Phila. Coll. of 
Pharmacy, Secretary to the Am. Pharm Association. With nume- 
rous illustrations. In one handsome octavo volume. 
The want has long been felt and expressed of a work which, within 
a moderate compass, should give to the physician and pharmaceutist an 
authoritative exposition of the pharmacopoeias from the existing stand- 
point of medical and pharmaceutical science. For several years the 
authors have been earnestly engaged in the preparation of the present 
volume, with the hope of satisfying this want, and their labors are now 
sufficiently advanced to enable the publisher to promise its appearance 
during the coming season. Their distinguished reputation in their re- 
spective departments is a guarantee that the work will fulfil all reasonable 
expectation as a guide in the selection, compounding, dispensing, and 
medicinal uses of drugs, complete in all respects, while convenient in 
size, and carefully divested of all unnecessary and obsolete matter. 



HENRY C. LEA-P>iiladelpliia. 



A 



GUIDE TO THERAPEUTICS 



AND MATERIA MEDICA. 



ROBERT FARQUH ARSON, M.D. Edin., 
F.R.C.P. Lond., 

LECTURER ON MATERIA MEDICA AT ST. MARY'S HOSPITAL MEDICAL 

SCHOOL, ETC. 



ENLARGED AND ADAPTED TO THE U. S. PHARMACOPOEIA 



BY 
FRANK WOODBURY, M.D., 

MEMBER OF THE ACADEMY OF NATURAL SCIENCES, PHILA., ETC. 










PHILADELPHIA: 

HENRY C. LEA. 

1877. 



\ 



^ 

<^1> 



Eatered according to the Act of Congress, in the year 1877, by 

HENRY C. LEA, 

in the Office of the Librarian of Congress. All rights reserved. 



COr-LINS, PRINTER. 



EDITOR'S PREFACE 



There is no more encouraging evidence of progress 
in medical science than the growing desire of the pro- 
fession for exact information concerning the action of 
remedial agents. A tendency towards empiricism, 
springing from too exclusive a reliance upon clinical 
teachings, finds its natural correction in increased 
familiarity with ascertained facts respecting the influ- 
ence of drugs upon the human system in health and 
disease; and no argument is needed to show that if 
therapeutics is ever to attain the precision of a science 
it must be based upon the fullest attainable knowledge 
of this kind. 

The present volume, though small in bulk, is 
an intelligent effort in this direction, containing, 
as it does, in moderate compass, such well-digested 
facts concerning the physiological and therapeutical 
action of remedies as are reasonably established up to 
the present time. By a convenient arrangement the 
corresponding effects in health and disease of each 
article are presented in parallel columns, not only ren- 
dering reference easier, but also impressing the facts 
more strongly upon the mind of the reader. 

A* (V) 



Vi EDITOR'S PREFACE. 

In reproducing the " Guide to Therapeutics," very 
considerable additions have been found desirable to 
adapt it thoroughly to the wants of the American stu- 
dent — additions which have seemed to warrant the in- 
sertion of the words " Materia Medica" in the title-page. 
Without altering the peculiar features of the original, 
some changes have been made in the arrangement, and 
very copious notes have been introduced, embodying 
the latest revision of the U. S. Pharmacopoeia, together 
with the antidotes to the more prominent poisons, and 
such of the newer remedial agents as seemed necessary 
to the completeness of the whole. All matter thus 
added will be found distinguished from the text by 
brackets []. 

It is hoped that the volume in its present shape will 
prove to be well suited to the wants of the student and 
junior practitioner, from its compendious form, and the 
clearness with which the leading facts of therapeutics 
and the materia medica are set forth. 

Philadelphia, November, 1877. 



PREFACE. 



In these days of profuse publication, a preface coming 
from any one who ventures to write a text-book must 
assume, in great measure, an apologetic tone. Elaborate 
and comprehensive works on Therapeutics now crowd 
our shelves, and the question may not unnaturally arise, 
what excuse can be given for adding another item to 
the rapidly increasing list ? In reply to this I can only 
express a hope that room may be found for a smaller 
handbook than those more elaborate treatises which 
reflect so faithfully the progress of modern science, and 
that my little bark may float peacefully by the side of 
more richly laden vessels without being entirely sub- 
merged by their waves. I cannot, of course, expect 
either to supersede or to rival the classical manuals of 
Ringer, Wood, and others, and all I aim at is to present 
the subject in briefer compass, in perhaps more sys- 
tematic form, and unencumbered by any botanical or 
pharmaceutical detail. 

Space has not enabled me to acknowledge the sources 
from which I have been enabled to compile the follow- 

(vii) 



Vlll PREFACE. 

ing pages ; and I can only express in general terms my 
grateful sense of the labors of many able and industrious 
workers in the field of Therapeutics. I have freely 
drawn much valuable material from the systematic 
works of Stille, Neligan, Garrod, Ringer, Wood, Bar- 
tholow, Phillips, Thorowgood, Nothnagel, Royle, and 
Christison ; and I have also derived important instruc- 
tion from the writings of Brunton, Handheld Jones, 
Fraser, Fothergill, John Harley, Anstie, Broadbent, 
Liebreich, and many others who have contributed 
important aid to the progress of our subject in later 
years. 

For many of my prescriptions I am more especially 
indebted to Bartholow, and to the very handy little 
" Lessons on Prescribing" by Dr. Hansell Griffiths. 

23 Brook Street, Grosvenor Square, W. 
April, 1877. 



CONTENTS. 



Introduction . . . 13 
General Rules for Pre- 
scribing . . .15 
Preliminaiy considerations 15 
Combination of Drugs . 16 
Form of Administration . 17 
Proper time for Exhibition 18 
Dosage . . . 19 

Interval between Doses . 21 
Individual Peculiarities . 22 
Idiosyncrasy . . .22 

Habit . . . .22 



Constitutional or Toxic effect 
from small doses . 

Chemical and Physiological 
Incompatibilities . 

Prescribing for Children 

Prescription-writing . 

Weights and Measures 

Observations upon Doses . 

General rule for Doses 
General Plan of Arrange- 
ment .... 



24 

25 
26 

28 

29 

30 
3i 

3 2 



SECTION I. 
Remarks on certain Classes of Remedies. 



Antidotes . 

Acids .... 

Anthelmintics . 

Antipyretics and Refrig- 
erants . 

Antiseptics and Disinfect- 
ants 



Remedies comprised in the Primary List of the United States 
Pharmacopoeia and their Preparations. 



• 37 


Counter-Irritants . . 47 


■ 38 


Diaphoretics . . .48 


. 42 


Diuretics . . . .50 


G- 


Emetics . . . . 51 


• 44 


Emmenagogues andEcbolics 54 


T- 


Expectorants . . -55 


• 45 


Purgatives . . -56 


SECTI 


ON II. 



Those marked * are not officinal. 



Absinthium 

Acacia 

Syrupus Acaciae 
Mucilago Acaciae 

Acetum 

Acetum Destillatum . 

Acidum Aceticum 

Acidum Aceticum Dilutum 

Aceta .... 

Acidum Arseniosum . 

Acidum Carbolicum Impur 

Acidum Carbolicum . 

Glyceritum Acidi Carbolici 
Unguentum Acidi Carbolici 
Suppositoria Acidi Carbolic 
Aqua Acidi Carbolici 



61 

61 
61 
61 
62 
62 
62 
62 
62 
64 
64 
64 
64 
64 
64 
64 



Acidum Chromicum . 

Acidum Citricum 
Syrupus Acidi Citrici 

Acid. Hydrocyanic. Dil 

Acidum Lacticum 

Acidum Nitricum 

Acidum Nitricum Dilutum 

Acidum Nitro - Muriaticum 
Acid. Nitro-Muriat. Dilut 

Acidum Oxalicum 

Acidum Tartaricum . 
Ferri et Ammonii Tartras 
Pulveres Effervescentes 
Pulv. Efferv. Aperientes 

Acida 

Aconitum . 

(ix) 



67 



69 

73 
73 

73 
75 
75 
75 
75 
75 
75 
75 
76 
76 



CONTENTS 



Aconiti Folia . 

Aconiti Radix . 

Aconitia . 

Extractum Aconiti 

Emplastrum Aconiti . 

Linimentum Aconiti . 

Tinctura Aconiti Radicis 
Adeps .... 

Ceratum . 

Unguentum 
Unguenta . 
./Ether 

/Ether Fortior . 

Spiritus iEtheris Compositus 
^Etherea 
Alcohol ... 

Alcohol Dilutum 

Alcohol Fortius 

Vinum Xericum 

Vinum Portense 

Spiritus Vini Gallici . 

Spiritus Frumenti 

Spiritus Myrciae 

Spiritus Genevae* 

Spiritus ^Etheris Nitrosi 

Spiritus ^Etheris Compos 
Spiritus 
Alcohol Amylicum . 

Amyl Nitris* . 
Allium 

Syrupus Allii . 
Aloe .... 

Aloe Barbadensis 

Aloe Capensis . 

Aloe Socotrina . 

Aloe Purificata . 

Pilulae Aloes 

Pilulae Aloes et Assafcetidae 

Pilulae Aloes et Mastiches 

Pilulae Aloes et Myrrhae 

Pilulae Rhei Compositae 

Pulvis Aloes et Canelhe 

Tinctura Aloes . 

Tinctura Aloes et Myrrhae 

Vinum Aloes 

Suppositoria Aloes . 
Alth^.a . 
Alumen 

Alumen Exsiccatum . 
Aluminii et Pot. Sulphas 
Aluminii Sulphas 
Ammoniacum 



76 
76 
76 
76 
76 
76 
76 

80 
80 
81 
81 
81 
81 
81 
81 

84 
84 
84 
84 
84 
84 
84 
84 
84 

91 

9 1 
9i 
91 
92 

94 
94 
95 
95 
95 
95 
95 
95 
95 
95 
95 
95 
95 
95 
95 
95 
95 
97 
97 
97 
98 
98 
98 



Mistura Ammoniaci . 
Pilulae Scillae Compositae . 
Emplastrum Ammoniaci 
Emp. Am. cum Hydrarg. 

Ammonium 

Aqua Ammoniae Fortior 
Aqua Ammoniae 
Linimentum Ammoniae 
Liquor Ammoniae Acetatis. 
Spiritus Ammoniae 
Spirit. Amnion. Aromaticus 
Tinct. Guaiaci Ammoniata 
Tinct. Valerianae Ammon 
Ammonii Benzoas 
Ammonii Bromidum . 
Ammonii Carbonas . 
Ammonii Chloridum . 
Ammon. Chlor. Purificatum 
Ammonii Iodidum 
Ammonii Nitras 
Ammonii Sulphas 
Ammonii Valerianas. 
Cuprum Ammoniaturn 
Ferri et Ammonii Citras 
Ferri et Ammonii Sulphas 
Ferri et Ammonii Tartras 
Hydrargyrum Ammoniaturn 

Nitrous Oxide Gas* . 

Amygdalus. 

Amygdala Amara 
Amygdala Dulcis 
Mistura Amygdalae . 
Oleum Amygdalae Amarae 
01. Amygdalae Expressum 
Aqua Amygdalae Amarae 
Syrupus Amygdalae . 

Amylum 

Angustura . 

Infusum Angusturae . 

Anisum 
Aqua Anisi 
Oleum Anisi 
Spiritus Anisi . 

Anthemis . 

Infusum Anthemidis . 
Oleum Anthemidis* . 

Antimonium 

Antimonii Sulphuretum 
Antimonii Oxidum . 
Antimonii et Pot. Tartras 
Antimonium Sulphuratum 
Antimonii Oxysulphuretum 



98 
98 
98 
98 
99 
99 
99 
99 
99 
99 
99 
99 
99 
99 
99 
99 
99 
99 
99 
99 
99 
99 
99 
99 
99 
99 

99 
104 

105 
105 
105 
105 
105 
105 
105 
io 5 
105 
106 

106 
106 
106 
106 
106 
106 
106 
106 
107 
107 
107 
107 
107 
107 



CONTENTS. 



XI 



Pil. Aritimonii Compositae 

Vinum Antimonii 

Emplastrum Antimonii 

Unguentum Antimonii 

Syr. Scillae Compositus 
Aqua .... 

Aqua Destillata 
Aquae .... 
Argentum . 

Argenti Cyanidum 

Argenti Nitras . 

Argenti Nitras Fusa . 

Argenti Oxiclum 
Arnica 

Extractum Arnicae 

Emplastrum Arnicae . 

Tinctura Arnicas 
Arsenicum. 

Acidum Ai-seniosum . 

Arsenici Iodidum 

Liq. Arsen. et Hydrar. Iod 

Liquor Arsenici Chloridi 

Liquor Potassii Arsenitis 

Sodii Arsenias . 

Liquor Sodii Arseniatis 

ASSAFCETIDA 

Mistura Assafcetidae . 
Tinctura Assafcetidae . 
Pilulae Assafcetidae 
Pilulae Aloes et Assafcetidae 
Suppositoria Assafcetidae 
Emplastrum Assafcetidae 
Pilulae Galbani Compositae 

AURANTIUM. 

Aurantii Amari Cortex 
Aurantii Dulcis Cortex 
Aurantii Flores. 
Aqua Aurantii Florum 
Syrupus Aurantii Florum 
Confectio Aurantii Corticis 
Syrupus Aurantii Corticis 
Tinctura Aurantii 

Aven^ Farina . 

Balsamum Peruvianum 

Balsamum Tolutanum 
Syrupus Tolutanus 
Tinctura Tolutana 

Barii Carbonas . 
Barii Chloridum 
Liquor Barii Chloridi 

Belladonna 

Belladonnae Folia 



107 
107 
107 
107 
107 
in 
in 
114 
115 
"5 
"5 
115 
ii5 
116 
116 
116 
116 
117 
117 
117 
117 
117 
117 
117 
117 
121 
121 
121 
121 
121 
121 
121 
121 
122 
122 
122 
122 
122 
122 
122 
122 
122 
123 
123 
123 
123 
123 
123 
124 
124 
124 
124 



Belladonnae Radix . 
Tinctura Belladonnae. 
Extractum Belladonnae 
Ext. Belladonnae Alcoholic 
Ext. Bellad. Radicis Fluid 
Emplastrum Belladonnae 
Unguentum Belladonnae 
Suppositoria Belladonnae 
Atropia 
Atropiae Sulphas 

Benzoinum . 

Acidum Benzoicum . 
Ammonii Benzoas 
Tinctura Benzoini 
Tinct. Benzoini Composita 
Unguentum Benzoini 

Oleum Bergamii . 

BlSMUTHUM . 

Bismuthi Subcarbonas 

Bismuthi Subnitras . 
Brominium . 

Ammonii Bromidum. 

Potassii Bromidum . 
Buchu 

Ext. Buchu Fluidum . 

Infusum Buchu . 
Cadmium . 

Cadmii Sulphas 
Caffea 

Caffeine* . 
Oleum Cajuputi . 
Calcium 

Calcii Chloridum 

Calcii Hypophosphis . 

Calx 

Calx Chlorinata 

Calcii Carbonas Praecipitata 

Calcii Phosphas Praecipitata 

Creta . . . . 

Creta Praeparata 

Hydrargyrum cum Creta 

Trochisci Cretae 

Mistura Cretae . 

Testa Praeparata 

Liquor Calcii Chloridi 

Liquor Calcis . 

Linimentum Calcis . 

Potassa cum Calce 
Calumba 

Extract. Calumbae Fluidum 

Infusum Calumbae 

Tinctura Calumbae 



Xll 



CONTENTS. 



Camphora . 

Oleum C amphorae 

Aqua Camphora? 

Linimentum Camphora? 

Spiritus Camphora? . 

Tinctura Opii Camphorata 

Linimentum Saponis . 

Mistura Chloroformi . 

Cerat. Plumbi Subacetatis 
Canella 

Pulvis Aloes et Canella? 
Canna. 
Cannabis Americana . 

Ext. Cannabis Americana? 
Cannabis Indica . 

Extractum Cannabis Indica? 

Tinctura Cannabis 
Cantharis . 

Tinctura Cantharidis . 

Ceratum Cantharidis . 

Ceratum Ext. Cantharidis 

Charta Cantharidis . 

Collodium cum Cantharid 

Linimentum Cantharidis 

Emp. Picis cum Canth. 

Unguentum Cantharidis 
Charta? 
Capsicum . 

Infusum Capsici 

Oleo-resina Capsici . 

Tinctura Capsici 
Carbo Animalis . 

Carbo Animalis Purificatus 
Carbo Ligni 
Cardamomum 

Tinctura Cardamomi . 

Tinct. Cardamomi Comp. 

Ext. Colocynthidis Comp. 

Pulvis Aromaticus 

Confectio Aromatica 
Carum 

Oleum Cari 
Caryophyllus . 

Infusum Caryophylli . 

Oleum Caryophylli . 
Cascarilla . 

Infusum Cascarilla? . 
Cassia Fistula . 
Cassia Marilandica . 
Castoreum . 

Tinctura Castorei 
Cataria 



139 
139 
139 
139 
139 
139 
139 
139 
139 
141 
141 
141 
141 
141 
142 
142 
142 

143 

143 
143 
H3 
143 
143 
143 
143 
H3 
143 
146 
146 
146 
146 

147 
147 

147 
149 
149 
149 
149 
149 
149 
149 
149 
149 
150 
150 
150 
150 
150 
150 
150 
150 
151 



Catechu .... 

Infusum Catechu Comp. 

Tinctura Catechu 
Cera Flava 

Cera Alba .... 
Cerata .... 

Cerii Oxalas 
Cetaceum .... 

Ceratum Cetacei 

Unguentum Aqua Rosas 
Cetraria .... 

Decoctum Cetrariae . 
Chenopodium 

Oleum Chenopodii . 
Chimaphila 

Decoctum Chimaphila? 

Extractum Chima. Fluidum 
Chiretta . 
Chloral 

Chloral- Camphor* 
Croton- Chloral* 
Aqua Chlorini . 
Acidum Muriaticum . 

Acidum Muriat. Dilutum . 
Chloroformum . 

Chloroformum Venale 

Chloroformum Purificatum 

Mistura Chloroformi . 

Spiritus Chloroformi . 

Linimentum Chloroformi . 
Chondrus .... 
ClMICIFUGA .... 

Extractum Cimicifugse Flu. 
Cinchona .... 

Cinchona Flava 

Cinchona Pallida 

Cinchona Rubra 

Cinchoniae Sulphas . 

Decoctum Cinchona; Flavae 

Extractum Cinchona? 

Extractum Cinchona? Flu. 

Infusum Cinchona? Flava? . 

Quinia? Sulphas 

Pilulas Quinia? Sulphatis 

Tinctura Cinchona? . 

Decoctum Cinchona? Rubra? 

Infusum Cinchona? Rubra? . 

Tinct. Cinchona? Composita 170 
Cinnamomum . . .179 

Oleum Cinnamomi . . 179 

Tinctura Cinnamomi . 180 

Aqua Cinnamomi . .180 



151 
151 
151 

152 
152 
152 
152 
152 
152 
152 
153 
153 
153 
153 
153 
153 
J 53 
154 
154 
159 
159 
160 
162 
162 
163 
163 
163 
163 
163 
163 
169 
169 
169 
170 
170 
170 
170 
170 
170 
170 
170 
170 
170 
170 
170 
170 
170 



CONTENTS 



Xlll 



Spiritus Cinnamomi . 
Pulvis Aromaticus 
Confectio Aromatica . 

Coccus 

Golchicum . 
Colchici Radix . 
Colchici Semen 
Extract. Colchici Aceticum 
Ext. Colch. Radicis Fluid 
Vinum Colchici Radicis 
Ext. Colch. Seminis Fluid 
Tinctura Colchici 
Vinum Colchici Seminis 

COLOCYNTHIS 

Extractum Colocynthidis 
Ext. Colocynthidis Comp. 
Pilulge Cathartica; Compos 
Confectiones 

CONIUM 

Conii Folia 

Conii Fructus . 

Ext. Conii Fructus Fluidum 

Extractum Conii 

Ext. Conii Alcoholicum 

Succus Conii 

Tinctura Conii . 
Copaiba 

Oleum Copaiba; 

Pilube Copaiba; 
Coptis 
coriandrum 
Cornus Florida 

Decoctum Cornus Florida; 

Ext. Cornus Florida; Fluid 
Creasotum . 

Aqua Creasoti . 

Unguentum Creasoti . 
Creta 
Crocus 
Cubeba 

Extractum Cubeba; Fluidum 

Oleo-Resina Cubeba; 

Oleum Cubeba; 

Tinctura Cubeba; 

Trochisci Cubeba; 

CUPRUM 

Cupri Subacetas 

Cupri Sulphas . 

Cuprum Ammoniatum 
Decocta 
Digitalis . 

Digitalinum 
B 



1 80 
180 
180 
180 
180 
180 
180 
180 
180 
180 
l8l 

i8i 
181 
182 
182 
182 
182 

183 

183 
183 
183 
183 

183 
183 

183 
186 
186 
186 
189 
189 
190 
190 
190 
190 
190 
190 
190 
190 
190 
190 
190 
191 
191 
191 
191 
191 
191 
191 
193 
193 
193 



Extractum Digitalis . . 193 

Ext. Digitalis Fluidum . 193 

Infusum Digitalis . . 193 

Tinctura Digitalis . . 193 

Dulcamara . •. .199 

Decoctum Dulcamara; . 199 

Extractum Dulcamara; . 199 

Ext. Dulcamara; Fluidum . 199 

Elaterium .... 200 

Elaterin* . . . . 200 

Emplastra .... 200 

Ergota . . . .201 

Extractum Ergota; Fluidum 20 1 

Vinum Ergota; . . .201 

Ergotine*. . . . 201 

Erigeron .... 204 

Erigeron Canadense . . 204 

Ext. Erigerontis Can. Fluid. 204 

Oleum Eriger. Canadensis 204 

Eupatorium . . . 204 

Infusum Eupatorii . . 204 

Extracta .... 205 

Extracta Fluida . . . 205 

Farina* . . . -205 

Fermentum . . . . 206 

Ferrum .... 206 

Ferri Hypophosphis . . 206 

Ferri Sulphuretum . . 206 

Ferri Chloridum . . 206 

Liquor Ferri Chloridi . 206 

Tinctura Ferri Chloridi . 206 

Ferri Citras . . . 206 

Liquor Ferri Citratis . . 206 

Ferri et Ammonii Citras . 206 

Ferri et Ammonii Sulphas 206 

Ferri et Ammonii Tartras . 206 

Ferri et Potassii Tartras . 206 

Ferri et Quiniae Citras . 206 

Ferri et Strychnia; Citras . 206 

Ferri Ferrocyanidum. . 206 

Ferri Lactas . . . 206 

Ferri Oxalas . . . 206 

Ferri Oxidum Hydratum . 206 

Ferri Phosphas . . . 206 

Ferri Pyrophosphas . . 206 

Ferri Subcarbonas . . 206 

Emplastrum Ferri . . 206 

Trochisci Ferri Subcarb. . 206 

Ferri Sulphas . . . 206 

Mistura Ferri Composita . 206 

Ferri Sulphas Exsiccata * 207 

Ferrum Redactum . . 207 



XIV 



CONTENTS. 



207 
207 
207 
207 
207 
207 
207 
211 
211 
211 
212 
212 
212 
213 



2I 3 
213 

21 



Pilula Ferri Carbonatis 
Pilulae Ferri Compositae 
Pilulae Ferri Iodidi . 
Syrupus Ferri Iodidi 
Liquor Ferri Nitratis 
Liquor Ferri Subsulphatis 
Liquor Ferri Tersulphatis 

Ficus .... 

Filix Mas . 

Oleo-resina Filicis 

Fgeniculum . 
Oleum Foeniculi 
Aqua Foeniculi . 

Galbanum . 

Emp. Galbani Compositum 213 
Pilulse Galbani Compositae . 213 

Galla. 

Acidum Gallicum 
Acidum Tannicum 
Tinctura Gallae . . -213 

Unguentum Gallae . -213 

Unguentum Acidi Tannici . 213 
Glyceritum Acidi Tannici . 213 
Glyceritum Acidi Gallici . 213 
Suppositoria Acidi Tannici 213 
Trochisci Acidi Tannici . 213 

Gambogia . . . .214 

Gaultheria . . .216 
Oleum Gaultheria . .216 

Gelsemium . . . .216 
Ext. Gelsemii Fluidum . 216 

Gentiana . . . .217 
Extractum Gentianae . . 217 

Ext. Gentianae Fluidum . 217 
Infusum Gentianae Comp. 217 
Tinct. Gentianae Composita 217 

Geranium . . . .218 
Extractum Geranii Fluidum 218 

Glycerina . . . .218 

Glycerita . . . .219 

Glycyrrhiza . . .219 
Ext. Glycyrrhizae Fluidum . 219 
Ext. Glycyrrhizae . 219 

Mistura Glycyrrhizae Comp. 219 
Troch. Glycyrrhizae et Opii 219 

Gossypii Radicis Cortex . 220 
Ext. Gossypii Radicis Fluid. 220 

Gossypium . . . .220 
Pyroxylon . . . 220 

Collodium . . . 220 

Collodium cum Cantharide 220 
Collodium Flexile . . 220 



Guaiacum . . . .221 

Guaiaci Lignum . .221 

Guaiaci Resinae. . .221 
Tinctura Guaiaci . _ . 222 
Tinct. Guaiaci Ammoniata 222 

Gutta-Percha . . .222 
Liquor Gutta-Perchae . 222 

Hematoxylin . . .222 
Decoctum Haematoxyli . 222 
Extractum Haematoxyli . 222 

Hedeoma .... 223 
Oleum Hedeoma . . 223 

Helleborus . . .223 
Extractum Hellebori . . 223 

Tinctura Hellebori . . 223 

HORDEUM .... 223 

Decoctum Hordei . . 223 

Humulus . . . .224 
Infusum Humuli . .. 224 

Tinctm-a Humuli . . 224 

Lupulina .... 224 
Ext. Lupulinae Fluidum . 224 
Oleo-Resinae Lupulinae . 224 
Tinctura Lupulinae . . 224 

Hydrargyrum . . . 224 
Emp. Amnion, cum Hydr. 224 
Emplastrum Hydrargyri . 224 
Hydrargyrum cum Creta . 224 
Pilulae Hydrargyri . . 224 

Unguentum Hydrargyri . 224 
Hydrarg. Oxidum Rubrum 224 
Ung. Hydrarg. Oxidi Rubri 224 
Hydrarg. Oxidum Flavum. 224 
Ung. Hydrarg. Oxidi Flavi 224 
Hydrargyri Sulph. Rubrum 224 
Hydrarg. Chloridum Mite . 224 
Pil. Antimonii Compositae . 225 
Pil. Catharticae Compositae 225 
Hydr. Chlor. Corrosivum . 225 
Hydrargyrum Ammoniatum 225 
Ung. Hydrarg. Ammoniati 225 
Hydrarg. Iodidum Rubrum 225 
Ung. Hydrarg. Iodidi Rubri 225 
Liquor Arsenici et Hydrar- 
gyri Iodidi . . . 225 
Hydrarg. Iodidum Viride . 225 
Hydrargyri Cyanidum . 225 
Liquor Hydrarg. Nitratis . 225 
Ung. Hydrarg. Nitratis . 225 
Hydrargyri Sulphas Flava . 225 
Hydrastis . . . -233 
Extract. Hydrastis Fluidum 233 



CONTENTS. 


XV 


Hyoscyamus 


233 


Spiritus Lavandula; . 


244 


Hyoscyami Folia 


233 


Spiritus Lavandula; Comp. 


244 


Hyoscyami Semen 


233 


Leptandra . . . . 


245 


Extractum Hyoscyami 


233 


Limones . 


245 


Ext. Hyoscy. Alcoholicum 


233 


Limonis Cortex 


245 


Ext. Hyoscyami Fluidum . 


233 


Limonis Succus . 


245 


Tinctura Hyoscyami . 


233 


Oleum Limonis . . 


245 


ICHTHYOCOLLA 


234 


Spiritus L'monis . . 


245 


Ignatia .... 


234 


Syrupus Limonis 


245 


Extractum Ignatia; . 


234 


Acidum Citricum 


245 


Infusa. .... 


235 


Syrupus Acidi Citrici 


245 


IODINIUM .... 


235 


Linimenta . 


246 


Tinctura Iodinii 


235 


LlNUM . 


246 


Tinctura Iodinii Composita 


235 


Oleum Lini 


246 


Liquor Iodinii Compositus 


235 


Lini Farina 


246 


Unguentum Iodinii . 


235 


Infusum Lini Compositun 


I 247 


Ung. Iodinii Compositum . 


235 


Linimentum Calcis . 


247 


Liq. Arsen. et Hydrar. Iod. 


235 


Lithium . 


248 


Syrupus Ferri Iodidi 


235 


Lithii Carbonas 


248 


Pilulae Ferri Iodidi . 


235 


Lithii Citras 


248 


lODOFORMUM 


237 


Lobelia 


249 


Ipecacuanha 


237 


Acetum Lobelia 


249 


Ext. Ipecacuanhas Fluidun 


t 237 


Tinctura Lobelia 


249 


Pulvis Ioecacuanhae Comp 


237 


Liquores . 


250 


Trochisci Ipecacuanha; 


237 


Lycopodium 


25 1 


Troch. Morph. et Ipecac. 


237 


Magnesium . 


25 1 


Syrupus Ipecacuanhas 


237 


Magnesii Carbonas . 


251 


Vinum Ipecacuanha; . 


237 


Magnesii Sulphas 


251 


Jalapa .... 


241 


Magnesia . 


251 


Extractum Jalapa; 


241 


Trochisci Magnesise . 


251 


Pulvis Jalapa; Compositus 


241 


Liquor Magnesia; Citratis 


251 


Resinae Jalapa; . 


241 


Manganesium 


. 253 


Tinctura Jalapa; 


241 


Manganesii Oxidum Nigrur 


1253 


JUGLANS .... 


242 


Manganesii Sulphas . 


253 


Extractum Juglandis . 


242 


Manna ' . 


■ 253 


JUNIPERUS . . . 


242 


Maranta . . 


• 253 


Infusum Juniperi 


242 


M ARMOR .... 


■■ 253 


Oleum Juniperi 


242 


Marrubium 


254 


Spiritus Juniperi Compos. 


243 


Mastiche . 


254 


Spiritus Juniperi 


243 


Pilulae Aloes et Mastiches 


. 254 


Kino .... 


243 


Matico 


• 254 


Tinctura Kino . 


243 


Extractum Matico Fluidun 


1 254 


Krameria . 


244 


Matricaria 


. 254 


Extractum Krameria; 


. 244 


Mel .... 


• 254 


Ext. Krameria; Fluidum 


■ 244 


Mel Despumatum 


. 254 


Infusum Krameria; 


. 244 


Mellita 


• 255 


Syrupus Krameria; . 


. 244 


Mentha Piperita 


. 255 


Tinctura Krameria; . 


. 244 


Aqua Mentha; Piperita; 


. 255 


Lactucarium 


. 244 


Oleum Mentha; Piperita; 


• 255 


Syrupus Lactucarii 


. 244 


Spiritus Mentha; Piperita; 


. 255 


Lavandula 


• 244 


Trochisci Mentha; Piperita 


e 255 


Oleum Lavandula; 


• 244 


Mentha Viridis . 


♦ 255 



XVI 



CONTENTS. 



Aqua Menthae Viridis 
Oleum Menthse Viridis 
Spiritus Menthse Viridis 

Mezereum . 

Extractum Mezerei Fluidu 
Unguentum Mezerei . 

Misturae 

MONARDA . 

Oleum Monardas 
Moschus . . 
Mucilagines 
Myristica . 

Spiritus Myristicas 

Oleum Myristicas 
Macis . . . . 
Myrrh A 

Tinctura Myrrhse 

Tinctura Aloes et Myrrh as 

Pilulas Aloes et Myrrhas 
Nectandra 
Nux Vomica 

Tinctura Nucis Vomicae 

Extractum Nucis Vomicae 

Strychnia . 

Strychnias Sulphas 
Olea .... 
Oleum ^Ethereum 
Oleum Morrhu^e 
Oleum Oliv/e 
Oleum Ricini 
Oleum Succini . 

Oleum Succini Rectificatum 
Oleum Theobrom^ . 
Suppositoria 
Oleum Thymi 
Oleum Tiglii 
Opium .... 

Acetum Opii 

Confectio Opii . 

Extractum Opii 

Emplastrum Opii 

Suppositoria Opii 

Suppositoria Plumbi et Opii 

Pilulas Opii 

Pilula Saponis Composita 

Pulvis Ipecac. Compositus 

Tinctura Opii . 

Tinctura Opii Acetata 

Tinctura Opii Camphorata 

Tinctura Opii Deodorata 

Trochisci Glycyr. et Opii 

Trochisci Morph. et Ipecac 



255 
255 
255 
255 
255 
255 
256 
256 
c 5 6 
256 
256 
256 
256 
256 
257 
257 
257 
257 
257 
258 

259 

259 

259 

259 

259 

262 

262 

262 

265 

265 

267 

267 

267 

268 

268 

268 

270 

270 

270 

270 

270 

270 

270 

270 

270 

270 

270 

270 

270 

270 

270 

270 



Liquor Morphias Sulphatis 


270 


Suppositoria Morphias 


270 


Vinum Opii 


270 


Morphia . 


270 


Morphias Acetas 


270 


Morphias Murias 


270 


Morphias Sulphas 


270 


Codeia* . 


279 


Narceia* . 


279 


Cryptopia* 


279 


Paramorphia or Tbebaia* . 


279 


Narcotina"* 


279 


Papaverina* 


279 


Meconin*. 


280 


Apomorphia* . 


280 


Origanum . 


280 


Oleum Origani . 


280 


Os 


280 


Ovum . 


280 


Pa paver . 


280 


Pareira . 


280 


Ext. Pareirae Fluidum 


280 


Infusum Pareirae 


280 


Pepg* . 


281 


Phosphorus 


281 


Acid. Phosphor. Glaciale . 


285 


Acidum Phosphoricum Dil. 


285 


Physostigma 


285 


Extractum Physostigmatis . 


285 


Pilulae. 


288 


PlMENTA . 


289 


Oleum Pimentas 


289 


Piper 


289 


Oleo-resina Piperis . 


289 


PlX BURGUNDICA . 


289 


Emp. Picis Burgundicae 


289 


Pix Canadensis . 


289 


Emp. Picis Canadensis 


289 


PlX LlQUIDA 


290 


Glyceritum Picis Liquidas . 


290 


Infusum Picis Liquidas 


290 


Unguentum Picis Liquidas . 


290 


Plumbum . 


291 


Plumbi Oxidum 


291 


Emplastrum Plumbi . 


291 


Liquor Plumbi Subacetatis 


291 


Liq. Plumbi Subacet. Dil. 


291 


Ceratum Plumbi Subacetatis 


291 


Lin. Plumbi Subacetatis . 


291 


Plumbi Acetas . 


291 


Suppositoria Plumbi . 


291 


Suppositoria Plumbi et Opii 


291 



CONTENTS. 



XV11 



Plumbi Carbonas 


. 291 


Infusum Quassiae 


• 3" 


Ung. Plumbi Carbonatis 


. 291 


Tinctura Quassiae 


• 3ii 


Plumbi Nitras . 


. 291 


Quercus Alba 


. 312 


Plumbi Iodidum 


. 291 


Decoctum Quercus Alba 


. 312 


Unguentum Plumbi Iodidi 


291 


Quercus Tinctoria . 


. 312 


Podophyllum 


• 295 


Resina 


• 3 12 


Extractum Podopbylli 


• 295 


Ceratum Resinae 


. 312 


Resina Podophylli 


• 295 


Ceratum Resinae Comp. 


. 312 


Potassium . 


. 296 


Emplastrum Resinae . 


. 312 


Potassa 


. 296 


Resinae 


. 312 


Liquor Potassae. 


. 296 


Oleo-Resinae 


• 3 12 


Potassa cum Calce 


. 296 


Rheum 


• 3*3 


Potassii Acetas . 


. 296 


Extractum Rhei 


• 3*3 


Potassii Carbonas Impura 


. 296 


Extractum Rhei Fluidum 


• 3i3 


Potassii Carbonas 


. 296 


Infusum Rhei . 


• 313 


Potassii Carbonas Pura 


. 296 


Pilulae Rhei 


• 3*3 


Potassii Bicarbonas . 


. 296 


Pilulae Rhei Compositas 


• 3*3 


Liquor Potassii Arsenitis 


■ 297 


Pulvis Rhei Compositus 


• 3*3 


Potassii Bitartras 


. 297 


Syrupus Rhei . 


3*3 


Potassii Chloras 


■ 297 


Syrupus Rhei Aromaticus 


• 3*3 


Trochisci Potas. Chloratis 


. 297 


Tinctura Rhei . 


■ 3*3 


Potassii Citras . 


297 


Tinct. Rhei et Sennae 


• 3*3 


Liquor Potassii Citratis 


297 


Vinum Rhei 


• 3*3 


Mistura Potassii Citratis 


• 2 97 


Rosa Centifolia 


3 J 4 


Potassii Cyanidum 


297 


Rosa Gallica 


• 314 


Potassii Ferrocyanidum 


297 


Oleum Rosse 


■ 314 


Potassii Hypophosphis 


297 


Aqua Rosae 


• 3H 


Ung. Potassii Iodidi . 


297 


Confectio Rosae 


3 J 4 


Potassii Nitras . 


297 


Infusum Rosas Comp. 


3H 


Potassii Permanganas 


297 


Mel Rosae 


3 J 4 


Liquor Potassii Permang. . 


297 


Syrupus Rosae Gallicae 


• 3H 


Potassii Sulphas 


297 


Unguentum Aqua Rosae 


3H 


Potassii Sulphis 


297 


Rosmarinus 


315 


Potassii Sulphuretum. 


297 


Oleum Rosmarini 


315 


Potassii et Sodii Tartras . 


297 


Rubus .... 


3*5 


Potassii Tartras. 


297 


Extractum Rubi Fluidum 


3*5 


Antim. et Potassii Tartras 


297 


Syrupus Rubi . 


3*5 


Ferri et Potassii Tartras 


297 


Ruta .... 


3*5 


Potassii Bichromas . 


302 


Oleum Rutae 


3*5 


Potassii Bromidum 


303 


Sabadilla . 


316 


Potassii Iodidum 


305 


Veratria 


316 


Prunum . . . 


310 


Unguentum Veratriae 


316 


Prunus Virginiana 


310 


Sabina . 


3*7 


Ext. Pruni Virgin. Fluid. . 


310 


Ceratum Sabinae 


3*7 


Ijnfusum Pruni Virginianae . 


310 


Extractum Sabinae Fluiduir 


' 3*7 


Syrupus Pruni Virginianae . 


310 


Oleum Sabinae . 


3*7 


Pulveres . 


3 11 


Saccharum . . . . . 


318 


Punica Granatum 


3 11 


Syrupus . 


318 


Granati Fructus Cortex 


3 11 


Syrupus Fuscus 


318 


Granati Radicis Cortex 


3" 


Syrupi . 


318 


Quassia . 


3" 


Saccharum Lactis 


318 


Extractum Quassiae . 


3 11 1 


Sago 


318 



XVlll 



CONTENTS. 



Salvia 

Infusum Salviae 
Sambucus . 
Sanguinaria 

Acetum Sanguinariae 

Tinctura Sanguinariae 
Santalum . 
Santonica . 

Santoninum 

Trochisci Santonini 
Sapo . 

Ceratum Saponis 

Emplastrum Saponis 

Linimentum Saponis 

Pilula Saponis Compositae 
Sarsaparilla 

Decoct. Sarsaparillae Comp 

Extract. Sarsaparillae Fluid 

Ext. Sarsap. Comp. Fluid 

Syrupus Sarsaparillse Comp 
Sassafras . 

Oleum Sassafras 

Sassafras Medulla 

Mucilago Sassafras Medulla 
Scammonium 

Resina Scammonii 

Ext. Colocynthidis Compos 
Scilla 

Acteum Scillae . 

Syrupus Scillae . 

Pilulae Scillae Compositae 

Syrupus Scillae Compositus 

Tinctura Scillae 

Extractum Scillae Fluidu 
Scoparius . 
Senega 

Decoctum Senegae 

Extractum Senegae 

Extractum Senegae Fluidum 

Syrupus Senegae 
Serpentaria 

Extr. Serpentariae Fluidum 

Infusum Serpentariae 

Tinctura Serpentariae 
Senna 

Confectio Sennae 

Extractum Sennae Fluidum 

Infusum Sennae 

Tinctura Rhei et Sennae 
Sevum 

Sinapis Alba 
Sinapis Nigra . 

Charta Sinapis . 



319 
319 
3*9 
3 : 9 
3*9 
3 J 9 
319 
320 
320 
320 
322 
322 
322 
322 
322 

323 
3 2 3 
3 2 3 
323 
323 
324 
324 
324 
324 
324 
324 
3 2 4 
325 
325 
325 
3 2 5 
325 
325 
325 
326 

327 
327 
327 
327 
327 
328 
328 
328 
328 
328 
328 
328 
328 
328 
329 
329 
329 
329 



Sodium 

Sodii Acetas 

Sodii Bicarbonas Venalis 

Sodii Boras 

Glyceritum Sodii Boratis 

Mel Sodii Boratis 

Sodii Carbon as . 

Sodii Chloridum 

Sodii Hypophosphis . 

Sodii Hyposulphis 

Sodii Nitras 

Sodii Sulphas . 

Sodii Sulphis . 

Soda 

Liquor Sodae 

Sodii Arsenias . 

Liquor Sodii Arseniatis 

Sodii Bicarbonas 

Trochisci Sodii Bicarb. 

Sodii Carbonas Exsiccata 

Sodii Phosphas . 

Liquor Sodae Chlorinatae 
Spigelia 

Extract. Spigeliae Fluidum 

Extractum Spigeliae et 
Sennae Fluidum 

Infusum Spigeliae 
Spiritus Frumenti 
spiritus myrci.e 
Spiritus Vini Gallici 
Statice 
Stillingia . 

Extract. Stillingiae Fluidum 334 
Stramonium 

Stramonii Folia 

Stramonii Semen 

Extr. Stramonii Foliorum 

Extr. Stramonii Seminis 

Tinctura Stramonii . 

Unguentum Stramonii 
Styrax 
Sulphur 

Sulphur Lotum 

Sulphur Sublimatum . 

Unguentum Sulphuris 

Sulphur Praecipitatum 

Sulphuris Iodidum . 

Ung. Sulph. Iodidi . 

Acidum Sulphurosum 

Acidum Sulphuricum 

Acidum Sulph. Aromat. 

Acidum Sulphuricum Dil 
Succi .... 



CONTENTS. 


XIX 


Tabacum 


• 340 


Ext. Valerianae Fluidum 


• 348 


Infusum Tabaci 


• 34o 


Infusum Valerianae . 


. 348 


Oleum Tabaci . 


• 34o 


Oleum Valerianae 


. 348 


Unguentum Tabaci . 


• 34o 


Tinctura Valerianae . 


. 348 


Vinum Tabaci . 


• 34o 


Tinct. Valerianae Ammon. 


348 


Tamarindus 


• 342 


Acidum Valerianicum 


• 349 


Tapioca 


. 342 


Ammonii Valei'ianas . 


• 349 


Taraxacum. 


. 342 


Quiniae Valerianas 


■ 349 


Extractum Taraxaci . 


• 342 


Vanilla 


349 


Ext. Taraxaci Fluidum 


■ 342 


Veratrum Album 


. 348 


Infusum Taraxaci 


• 342 


Veratrum Viride 


350 


Succus Taraxaci 


• 342 


Extract. Verat. Vir. Fluid 


35° 


Terebinthina 


343 


Tinctura Veratri Viridis 


• 35° 


Terebinthina Canadensis 


• 343 


Vina .... 


35i 


Oleum Terebinthinae . 


• 343 


Zincum 


35i 


Linimentum Terebinthinae 


• 343 


Zinci Oxidum . 


- 35i 


Ceratum Resinae Comp. 


• 343 


Ung. Zinci Oxidi 


35i 


Collodium Flexile 


• 343 


Zinci Oxidum Venale 


35 1 


Testa. 


• 346 


Zinci Chloridum 


35i 


Testa Praeparata 


346 


Liquor Zinci Chloridi 


35i 


Tinctura 


. 346 


Zinci Acetas 


35i 


Tragacantha 


347 


Zinci Carbonas Praecipitate 


L 351 


Mucilago Tragacantha 


• 347 


Cerat. Zinci Carbonatis 


• 351 


Trochisci . 


347 


Zinci Sulphas . 


351 


Ulmus. 


347 


Zinci Valerianas 


351 


Mucilago Ulmi . 


347 


Zingiber . 


353 


Uva Passa .... 


347 


Ext. Zingiberis Fluidum 


353 


Uva Ursi .... 


347 


Infvfsum Zingiberis . 


353 


Decoctum Uvae Ursi . 


347 


Oleo-resina Zingiberis 


353 


Ext. Uvae Ursi Fluidum 


347 


Syrupus Zingiberis . 


354 


Valeriana .... 


348 


Tinctura Zingiberis . 


354 


Extractum Valerianae 


348 


Trochisci Zingiberis . 


354 


S 


ECTK 


3N III. 




Remedies in Frequent Usi 


:, BUT 


not included in the Prii 


tfARY 


I 


.1ST, t 


J. S. P. 




Apiol 


364 


Laurocerasi Folia 


3 6 3 


Acidum Salicylicum . 


365 


Leeches . 


368 


AZEDARACH .... 


355 


Liquor Ferri Dialysatus . 


362 


Areca .... 


356 


Mori Succus 


3^3 


Brayera .... 


355 


Pepsin . 


363 


Bel^: Fructus . . 


356 


Petroselinum 


364 


Curcuma .... 


356 


PlLOCARPIA . 


358 


Eucalyptus Globulus . 


356 


Rhamni Succus . 


364 


Fel Bovinum Purificatum . 


357 


ROTTLERA . 


3(>3 


Goa Powder 


357 


Salicin . . . 


364 


Jaborandi .... 


357 


SUMBUL 


367 


Kamala .... 


363 


Trimethylamine and ITS 




Laricis Cortex . 


363 


Hydro-Chlorate. 


' 368 


Questions for the Student 


: . 





369 


Index of Diseases and the] 


R REI 


dEDIES . . 


375 








39 1 



A GUIDE 



TO 



THERAPEUTICS 



INTRODUCTION. 

Previous to the study of the individual articles com- 
prised within our national Pharmacopoeia, the temptation 
is very strong to launch forth into a disquisition on the 
general principles of therapeutics. So many interesting 
physiological considerations are involved in the actions and 
uses of drugs, and so many important illustrations might 
readily be drawn from the wide field of practical medicine, 
that little apology would really be needed for consuming 
some of our space in this way. Therapeutics has lately 
shown a systematic vitality which amply redeems its credit 
from the old-fashioned accusation of want of progress, and 
perhaps in no other department of our profession have 
more solid and satisfactory advances been made. But 
this very condition of vigor renders far more laborious 
and responsible the task of attempting to reduce to any- 
thing like precision the laws on which we are henceforth 
to prescribe our drugs, or to draw complete generalisations 
from the enormous mass of complicated material now at 
our disposal. Progress may occasionally cause temporary 
confusion by disturbing old beliefs, and furnishing vast 
legions of sometimes unconfirmed and possibly ill-digested 
facts ; and our present subject is by no means exempt from 
this almost inevitable tendency of true science. 

A careful study of the many exhaustive works on thera- 
peutics published within the last twenty years brings before 
us a strange medley of experimental evidence, confusing 
and contradictory it may be at times, but giving most en- 

2 (13) 



14 INTRODUCTION. 

couraging proofs of the large amount of honest and per- 
severing work now being devoted to the elucidation of 
this the most important department of the materia medica. 
In the following pages we must necessarily assume a dog- 
matic attitude, and if the extreme precision with which 
our plan compels us to lay down the actions of drugs 
offends many whose faith is undeveloped or wavering, 
we can only excuse ourselves by a conscientious desire to 
contribute something towards a more scientific scheme 
of arrangement. Although the time has not yet fully 
come for a complete explanation of all the therapeutical 
effects of medicinal agents by their proved physiological 
properties, I have ventured to take a step in this direction, 
and must only hope that my very defects and failures may 
be of use in helping others to develop my principles with 
greater success. 

I shall give no systematic sketch of the different ways 
in which drugs enter the system, as they will be sufficiently 
indicated in the pages which follow, and as the student 
will derive much greater benefit by drawing up a scheme 
of the kind for himself than by lazily running his eye over 
the cut-and-dried conclusions of a text-book. I am 
anxious, if possible, to relieve my little work from the ac- 
cusation of being a mere grinding manual; for although I 
am not without hope that the systematic arrangement ad- 
opted may be of some service for examination purposes by 
putting the student's ideas and recollections in orderly 
iorm, I should also venture to anticipate that practitioners 
may also be able to turn to its pages for suggestion and 
instruction. Although I have not, as a rule, given the 
doses of every drug and every preparation, I have in 
most cases finished my account of each by a prescription, 
which will not only embody the average quantity usually 
employed, but will also indicate the best and most pal- 
atable way of combining the special remedial agent. 

Another feature of some importance I should consider 
the series of questions with which my work concludes, and 
which aim at being in the light of ' puzzles' as Mrs. Faucett 
expresses it in her admirable little manual of 'Political 
Economy,' or of suggestive teachings on the border- land 
between therapeutics and medicine, than as the sort of 
somewhat sapless query and reply affected by educational 
treatises. 



RULES FOR PRESCRIBING. 15 

GENERAL RULES FOR PRESCRIBING. 

Preliminary Considerations. — It will be well, before 
proceeding further, that I should lay down some broad 
rules which may guide us in the construction of prescrip- 
tions ; and it seems best to introduce this subject here, 
instead of placing it, according to more usual custom, at 
the end of the book, as it is to be our aim and object to 
devote much care and attention throughout to the best 
modes of ordering drugs. Much professional credit may 
be derived from a good prescription, and as much damage 
done to the practitioner who orders for his patients mix- 
tures which are neither agreeable to the eye nor palatable 
to the taste. It is well worthy of the student's attention to 
consider the most pleasant, effectual, and convenient way 
of ordering the drugs which are required by the sick, and 
at first he will no doubt consider this a very difficult task. 
This will partly depend on the fact that he has had the 
subject of doses and therapeutical actions presented to him 
in such concentrated form that he will find some awkward- 
ness in using practically the theoretical knowledge which 
he has presumably obtained. The time at his teacher's 
disposal is so short that he has to run hurriedly from one 
drug to another, and bring into immediate relation reme- 
dies which differ so widely in their effects as to excite some 
not unnatural confusion in the minds of his hearers. It is 
therefore not an uncommon thing to hear students say that 
they do not think they will ever be able to remember the 
doses of the principal medicines. Then we must remember 
that, during attendance on out-patient practice, prescribing 
is either done on very routine principles, or considerations 
of time and convenience render it advisable to order most 
drugs according to registered formulae, which are merely 
referred to on the patient's letter by name. Thus, although 
the student may know that dyspepsia may be treated by 
mist. alk. amara, or debility by mist, quiniae, he would 
perhaps experience some difficulty in writing a prescription 
suitable for either case. In the wards, of course, he sees 
much more prescribing, but is perhaps not often called 
upon to do it for himself, so that, when he settles down on 
his own account, it will be some time before he can handle 
medicines with that ease, confidence, and certainty, which 
can alone conduce to the comfort of his patients and his 



l6 INTRODUCTION. 

own ultimate success. Now it cannot be out of place to 
urge upon him here the great importance of frequently 
exercising himself in this art. Let him put problems to 
himself, let him run his eye through his text-books, and 
endeavor to order the various drugs in varied combination ; 
when he meets with the recommendation to treat a certain 
disease in a certain way, let him there and then expand 
these more or less. vague directions into the form of a 
prescription ; and so at last due blending of ingredients, 
with the avoidance of incompatibles and the concealment 
of nauseous properties, will come to him with perfect ease 
and efficiency. 

i. Combination of Drugs. — The first thing to be con- 
sidered in writing a prescription is the object for which we 
order this certain combination of drugs, which symptoms 
in our patient's case do we wish to alter or modify, what 
is to be our principal ingredient, and in what quantity. 
This being duly settled in our minds, we reflect whether 
it is better to give this particular article by itself, or to 
combine it with other substances, which may possibly as- 
sist or mitigate its action, or may at all events conceal its 
more or less nauseous taste. Now it is a very commonly 
given recommendation that in our prescriptions we should 
aim at simplicity as much as possible, and this certainly 
holds good within certain limits. The old-fashioned cus- 
tom used to be to string together a long list of ill-under- 
stood substances in the hope that some one or other of 
them might hit the right nail on the head, and even now 
traces of this polypharmacy linger about medical practice. 
When, however, we are tolerably certain of the action of 
our drug, and more especially when we are making scien- 
tific observations on its mode of action, it is often of great 
importance that we should not obscure its effects by the 
addition of any other active substances, but order it either 
simply in distilled water, or merely combined with other 
ingredients for flavoring purposes. But we must remember 
not to carry this principle too far. No fact is more tho- 
roughly proved in therapeutics than the value, under certain 
conditions, of due combination, and the way in which one 
drug may assist the action of another. 

Thus, taking the case of diuretics, we know well that a 
prescription containing three or four members of this group 
will often act where one produces little or no effect, and 



RULES FOR PRESCRIBING. 17 

that mercury is of undoubted service in assisting the in- 
fluence of squill and digitalis over the urinary secretionk 
Cough medicines are always best given in combination 
with a variety of drugs, and the same holds good of pur- 
gatives; for we all know how hyoscyamus or belladonna 
will both aid and hold in check the action of colocynth, 
how a little sulphuric acid and iron will promote that of 
sulphate of magnesia, how jalap aids the peristaltic intestinal 
contraction to remove the watery fluid which cream of tar- 
tar drains into the bowels. 

Several alkaline medicines given together seem to act 
better in rheumatic fever than the simple administration of 
one member of the group. Tonics, such as quinine and 
iron, are blended with advantage. Then again, we add 
one drug to another for the purpose of counteracting some 
unpleasant physiological effect; thus spiritus ammonii 
aromat. mitigates the unpleasant symptom of iodism, and 
atropia lessens the chances of discomfort which attend the 
subcutaneous injection of morphia. Instances like this 
might be multiplied almost ad infinitum j but we shall de- 
velop the subject further as we go on, and refer frequently 
to the laws which should guide us in considering whether 
the various drugs are best ordered singly or in combination. 1 

2. Form of Administration. — We must take into con- 
sideration whether we ought to administer our drug in a 
concentrated or diluted form, and here again we shall find 
it necessary to act very differently under different circum- 
stances. As a general rule, we may lay down that the 
metals are best given either in pill or in a small quantity 
of fluid, and this remark applies more especially to those 
which have very active physiological properties. Thus we 
generally give arsenic and perchloride of mercury [corro- ' 
sive sublimate] in a state of only moderate dilution. Salts, 
on the other hand, and more especially the purgative salts, 
act best when taken in large quantities of fluid, and we 

1 As well-known examples of this rule we have to remind our readers 
of the composition of the ext. coloc. co. and pil. coloc. co. [Ph.B.], 
both of which contain aloes and scammony in addition to the ingredient 
which gives its name to the mass — the idea being, no doubt, to secure 
the combined and harmonious action of several purgatives acting on 
different tracts of intestine; this harmony, so to speak, being aided, 
and griping obviated, by the addition of aromatics, such as cardamoms 
and cloves respectively. 



l8 INTRODUCTION. 

V shall find in practice that iodide of potassium is decidedly- 
more efficacious when freely diluted, that sulphate of mag- 
nesia follows the same rule, and that in the case of diuretics 
also we may aid their action by combining the directly 
flooding or mechanically sluicing effect on the kidney, of 
large quantities of watery fluid. 

3. Proper Time for Exhibition. — The period of ad- 
ministration is also welT deserving of careful study, and 
we may indicate one or two useful rules with regard to the 
action of alkalies and acids. As acids check acid secre- 
tions, and alkalies have a similar influence over those with 
alkaline reaction and vice versa, we can readily understand 
the effect which they may exercise over digestion. Thus 
an acid given directly before a meal must interfere with 
the due assimilation of the nitrogenous articles of diet by- 
checking the supplies of gastric juice, whereas an alkali 
given at the same time must theoretically produce the best 
results by stimulating that secretion. If, on the other 
hand, we give an alkaline medicine after food, we do harm 
by directly neutralizing the acid on which some part at 
least of the active principles of the gastric juice depends. 1 

Drugs which have a distinctly lowering or irritating effect 
on the system are best given with or after meals, so as to 
prevent these results as far as possible; thus we always 
give arsenic or corrosive sublimate at these times, and find 
that they are well borne by persons who could not take 
them on an empty stomach. For a different reason, again, 
we generally find it convenient to prescribe cod-liver oil 
after food, not only because it is less likely to cause sick- 
ness when given in that way, but because oily matters being 
absorbed by the lacteals are most readily taken up when 
these structures are in full working order. 

Again, when we wish to imitate or excite a normal phy- 

[' An important point for the student to learn at the outset is, that 
nothing can be more fallacious than a priori reasoning concerning the 
therapeutical effects of remedies. Cases of atonic dyspepsia with 
acidity of the stomach are frequently benefited by dilute mineral acids; 
and a combination of muriatic acid (gtt. iij.) with pepsin (gr. x.) in 
water (f^ss.) given directly before meals, is constantly prescribed with 
good results for patients with impaired or weak digestion. Indigestion 
with pyrosis, or flatulence, may be relieved by alkalies after meals, as 
in the pleasant preparation known as soda mint (see Sodii bicarb.), to 
which may be conveniently added tincture of nux vomica, or syrup of 
rhubarb, according to the judgment of the prescribe! - .] 



RULES FOR PRESCRIBING. 19 

siological action, we must time our drug accordingly. 
Opium or any other narcotic is much more likely to pro- 
duce sleep when taken at night than at other times, and*/ 
a mild purgative in the morning will often stimulate the y 
peristaltic movement of the intestines to evacuate the 
bowels at the time when they are accustomed to act. 

The efficacy of purgatives is also markedly aided by a 
due consideration of the periods at which they ought to 
be given. A resinoid cathartic principle contained in 
pill is usually of slow and deliberate action, and may be 
given indifferently with meals — as in the case of dinner- 
pills — or on an empty stomach before bed-time ; but 
saline purgatives generally act best when given fasting, 
as the veins of the intestinal tract are then less full and 
more predisposed to rapid absorption. As an illustra- 
tion of this we need only refer to the much more potent 
effect of an ordinary seidlitz powder given before than 
after breakfast. 

Anthelmintics, again, are always best given after as long 
a fast as possible, so that the parasites which they attack » 
may not be shielded by food or mucus, and we find in 
practice that night, just before bed-time, is the most con- 
venient period for their administration. 

4. Dosage. — The relative efficiency of large and small 
doses is the next point which has to be taken into consider- 
ation ; and here we are at once confronted by some of the 
most delicate and difficult questions in therapeutics — del- 
icate because they border closely on the dangerous ground 
of homoeopathy, difficult on account of their often unsettled 
nature. We cannot pretend to give any exhaustive dis- 
cussion to this branch of our subject, because the mate- 
rials for it are not forthcoming, but we can all contribute 
somewhat to its solution by experimental trials of various 
drugs given in these different ways. This much, however, 
we do know, that in many cases we get much more satis- 
factory results [in special emergencies, or temporary con- 
ditions] by giving one tolerably large dose at one time; 
and especially is this the case with narcotics, small quan--- 
tities of which only excite and annoy, whilst a full dose 
satisfactorily brings about the desired result of sleep. Pur- 
gatives and emetics, again, are also best given in one con- 
siderable dose; tonics, astringents, diuretics, &c, require to 
be steadily repeated at certain short and regular intervals 



20 INTRODUCTION. 

[in order to have a sustained and continued effect]. But 
the true point at which we wish to arrive is this : Can we 
best obtain rapidly and efficiently the constitutional action 
of a drug such as belladonna, or aconite, by administer- 
ing in average quantities two or three times a day, or by 
ordering it to be taken in very small doses often repeated? 
Now supposing we are called upon to treat a case of acute 
tonsillitis or catarrhal febrile disturbance, which we wish 
to remove as rapidly as possible, and we elect aconite as the 
special remedy to be used, we are taught by Ringer and 
others that the most reliable method for its administration 

s is in drop or even half-drop doses every hour, half-hour, 
or even ten minutes. General experience has pretty well 
confirmed this teaching, and has extended it to other 

.medicines, such as prussic acid, which will thus more 
effectually control urgent sickness than when given at longer 
intervals in the more orthodox way; to tartar emetic, which 
in very small and often-repeated quantities exercises a re- 
markable effect over infantile bronchitis; to ipecacuanha, 
which in minim doses will frequently check obstinate vomit- 
ing; to calomel and grey powder, which in minute doses, 
every half-hour, will often stop irritability of the stomach 
when nothing else will succeed. Instances of this sort will 
be multiplied as our consideration of the individual articles 
of the Pharmacopceia goes on, the principle being steadily 
kept in mind that we may often bring the system much 
more efficiently under the special influence of a drug, by 
ordering it in small quantity often repeated, than by giving 
full doses two or three times a day; and this necessarily 
applies with special force to those drugs which are rapidly 
thrown out of the system, and whose action upon the struc- 
ture or function they are particularly supposed to effect, is 
thus kept up and, so to speak, perpetuated by very frequent 
administration. 

On the other hand, we must not forget that certain 
medicines must be given in very large quantities before 
their physiological properties are obtained. Thus it 
would be useless to expect succus conii to tranquillise ir- 
regular muscular movement in less doses than f5j. [Ph.B. 
The succus conii, U. S., cannot be safely given in such 
large amounts, as its strength is variable. Dose, to begin 
with, fjss.-j.], and frequently we require to give even more 
than this ; belladonna is of no use in nocturnal inconti- 



\ 



RULES FOR PRESCRIBING. 21 



ence of urine unless boldly pushed up to f5j- or fjjss. of 
the tincture. [In this connection it should be borne in 
mind that the tincture of belladonna of the U. S. Pharma- 
copoeia is twice the strength of the British.] Arsenic acts 
best in chorea when prescribed with no timid hand. 

Another point of interest in connection with this enquiry 
is that, drugs often display different and even opposing 
actions, according as they are given in large or small 
doses. Thus we have seen that drop doses of vin. ipecac, 
will often check vomiting, whereas it is well known that 
a teaspoonful, or even less, will almost immediately evacu- 
ate the stomach ; sulphate of zinc, in twenty or thirty grain 
doses, is prized as our best emetic, whilst it is equally 
established that from one to six grains is a valuable ner- 
vine tonic, much used by some physicians in the treatment 
of chorea. Small doses of opium excite, whilst large 
soothe into sleep; half-ounce doses of [infusion of] digitalis 
may be more safely given than those of f 5j. [more frequently 
repeated] ; the neutral ',salts of potash and soda are, as a 
rule, purgative in large, diuretic in small doses ; and the 
other instances of this principle — which will afterwards be 
given — must be borne in the mind of the prescriber before 
he can pretend to make most efficient use of the weapons 
t his disposal. 

5. The Interval between Doses. — The next heading 
to which reference is usually made is regarding how often 
we ought to repeat our dose of medicine ; but this is so 
far involved in what has gone before, that very little remains 
to be said. The ordinary rule is to order our mixture to be 
taken three times a day, or every four hours, unless spe- 
cial circumstances, such as we have already indicated, 
render it advisable to repeat more frequently. Although 
many sick persons look forward to the time of taking their 
physic, and feel moral as well as physical support from 
the mere act of attending to their doctor's orders, the 
greater proportion are not so favorably impressed, and 
would willingly be relieved from the necessity of swallow- 
ing the often nauseous compounds they receive. Homoeop- 
athists, no doubt, derive much of their success from the 
tasteless nature of their medicines, and we have not yet 
devoted sufficient attention to the elegances and refine- 
ments of pharmacy. It is well) therefore, to direct our 
tonics and astringents, and drugs whose action is to be 



22 INTRODUCTION. 

spread over some considerable time, to be taken three 
times a day, always bearing in mind those important ex- 
ceptions which recent investigation has done such good 
service in impressing upon our attention. 

6. Individual Peculiarities ; Idiosyncrasy; Habit. 
— When the student has been fairly emancipated from the 
leading-strings of his teachers, and enters practice on his 
own account, he will often be disappointed at the way in 
which drugs play their allotted parts. The necessarily 
cut-and-dried and dogmatic descriptions of the text-books 
have led him to believe that such and such a medicine 
will always act in a particular way, and he accordingly 
prescribes it with full confidence in a given case. But not 
only may the proper effects fail of development, but very 
unpleasant and almost unlooked-for symptoms may follow 
its use, which will be productive of much discomfort and 
uncertainty, and may even tend to shake his professional 
credit. The influence of that strange individual peculia- 
rity, usually termed idiosyncrasy, and of which no rea- 
sonable explanation has ever been given, must be very 
carefully taken into account in prescribing, and we shall 
refer to it on all suitable occasions. Sometimes it renders 
our patient unduly susceptible to the action of drugs, and 
thus we may find one person seriously salivated by one 
grain of calomel, another who dare not touch quinine, a 
third who is furiously excited by opium, whilst a fourth 
may be poisoned by a single grain of morphia. Phosphorus 
and bromide of potassium also cause their peculiar effects 
in very small doses. A good precaution, therefore, is, 
before prescribing any of these drugs, to ascertain from 
the patient whether he has ever taken any of them before, 
and whether no uncomfortable effects could be in any way 
attributable to their use. But, on the other hand, our 
patient's constitution may be such that very large quanti- 
ties of drugs will alone succeed in acting ; and remarkable 
stories are told by Christison and others of the immense 
quantities of opium which persons quite unaccustomed to 
its use have been occasionally able to take with impunity. 
Purgatives act very differently on different people, and 
others require immense quantities of anaesthetic vapor be- 
fore full insensibility is obtained. Although, as I have 
iust said, we may often anticipate uncomfortable effects by 
"due preliminary inquiry, it too often happens that they 



RULES FOR PRESCRIBING. 23 

come on suddenly, and quite unexpectedly. Idiosyncrasy 
is so wide-spread and deep-rooted in the human constitu- 
tion, in almost every function and action, that we can 
hardly hope ever to obtain the key to its mysteries. Why, 
may we ask, do particular articles of diet disagree with 
special persons? Why does one person, on exposure to 
cold, take a simple catarrh, whilst a second becomes a 
prey to rheumatic fever, and a third escapes unharmed ? 
Why do we all differ from 'one another in some minor de- 
gree in almost everything that we do ? Until we can clear 
up these problems, it is vain for us to attempt to explain 
why we require to adapt our doses so carefully to indivi- 
dual constitution and peculiarity ; and the reason why the 
student is at first perplexed by all this is that we meet with 
these differences much more frequently in the upper ranks 
of society. The hospital or dispensary patient swallows 
any dose, however nauseous, with much satisfaction, and is 
much less often affected by those troubles of irregular phy- 
siological action which so frequently harass the family 
medical attendant in more aristocratic circles. 

The influence of habit on therapeutics is also worthy of 
every consideration, for we shall find in practice that 
medicines often lose their effect when continued for any 
lengthened period. More especially is this the case with 
opiates and narcotics generally, the dose of which requires 
to be gradually increased from time to time. Arsenic has 
the same peculiarity, as is shown in the case of the arsenic- 
eaters of Styria, who, by long continuance in the use of 
that substance, are at last able to consume quantities which 
would inevitably prove fatal to a novice. And this leads 
to the question of toleration, an old-fashioned term dating 
from the days of heavy dosing with irritating metallic sub- 
stances, but having sufficient bearing on modern practice 
to justify its consideration here. We have said that the 
term toleration savors somewhat of antiquity, because the 
great illustration of this principle used to be afforded by 
tartar emetic, which was then much more freely used than 
now in acute inflammations ; and when I say antiquity I 
do not refer to anything more remote than perhaps half a 
century ago. Then the contra-stimulant treatment of 
pneumonia was in full swing, and the curious fact became 
gradually known that, although the first doses of tartar 
emetic often caused much nausea and depression, subse- 



24 INTRODUCTION. 

quent larger quantities were well borne ; and this was ex- 
plained by what was called toleration of the drug being 
established in the system. It will be seen, when we come 
to consider in detail the actions and uses of tartar emetic, 
that a very sufficient and scientific explanation can be given 
of this somewhat mysterious effect. In these days, inflam- 
matory action is treated on somewhat different principles, 
and antimony is comparatively little used ; but the prin- 
ciple of toleration can be recognized in the use of other 
drugs. Thus, in dysentery, quantities of ipecacuanha are 
given which would infallibly produce violent vomiting in 
a healthy subject ; arsenic is better borne in skin disease 
than in a state of health ; choreic patients are able to 
swallow almost emetic doses of zinc sulphate without the 
action of vomiting being induced. Digitalis is well 
known to be given freely in delirium tremens, and there 
is little doubt that the experiment of prescribing half an 
ounce of the tincture to a person in ordinary health would 
be productive of serious if not fatal consequences. Further 
instances of toleration might readily be adduced, but it will 
be much more to the advantage of the student to recom- 
mend him to pick out other examples for himself than to 
provide him with a cut-and-dried list of all that is known 
on the subject. 

7. Constitutional, or Toxic, Effect from Small 
Doses. — We next come to what is commonly known as 
accumulation, the theory of which is that certain drugs rest 
or become stored up in the system until they reach a 
dangerous quantity, when inconvenient or poisonous 
symptoms may result. Thus we know that after a certain 
continuance in the use of digitalis, faintness and depression 
have often been observed, that strychnia may cause uncom- 
fortable twitchings after it has been taken for some time, 
that bromide of potassium only begins to cause annoyance 
when the system seems to have become saturated with the 
salt. Does this really mean that these substances have 
reached the point beyond which their poisonous action is 
neutralised, so to speak, by the symptoms which their 
therapeutical powers attack, or is the defect in the organs 
of elimination which fail to expel them efficiently from the 
system? It is probable that both these and the numerous 
other examples which our subsequent pages will contain 
depend on both these causes in some degree, in addition 



RULES FOR PRESCRIBING. 25 

to another, and that is that the organ or tissue towards 
which the physiological action of the drug is directed is, 
after long-continued stimulation by repeated small doses, 
worked up into a certain condition of special excitement 
or depression, and discharges accordingly. Thus we find 
the twitchings from strychnia, the cardiac depression of 
digitalis, the nervous weakness and ataxy from bromide of 
potassium, the paralysis resulting from alcohol. The 
metals, as mercury, arsenic, &c, on the other hand, no 
doubt act by being stored up within the tissues, and 
brought into excessive action by some defect of elimina- 
tion. 

And the practical outcome is, that in prescribing many 
of these drugs, and more especially digitalis, strychnia, 
and bromide of potassium, it is well to have an occasional 
break, to omit our prescription for a day or two, so as to 
give the parts a rest, and enable the remedy to act after- 
wards with better effect in even diminished dose. 

8. Chemical and Physiological Incompatibilities. 
— And now we come to the doctrine of incompatibility, 
which is of all-essential importance in therapeutics, con- 
sisting as it does of the principles which we require to 
know in order to avoid that amount of clashing of the 
different ingredients of our prescription which may either 
alter or destroy their action. Now incompatibility may 
be of different sorts, and is generally divided into chemi- 

Ucal and physiological. Of these we will first consider 
chemical incompatibility. 

This consists in the chemical reactions of one drug on 
another, which may result in the formation of a new com- 
pound when they are mixed. Thus the addition of iron 

. to decoction of cinchona will produce an unsightly, black 
mixture; strychnia and perchloride of mercury will not 

v go with gelatine; sulphuric acid and lead form an insoluble 
sulphate. A good deal of this incompatibility, however, 
is inconvenient, principally, because the resulting solution 
is often thick, turbid, and unsightly, and therefore repug- 
nant to the patient. Many most incompatible mixtures 
are therapeutically efficient, and some are even prescribed 
deliberately. Quite otherwise is it, however, with the 
second group, or the physiological incompatibles, the 
rationale of which is that the action of one drug is so far 
antagonistic to that of another that the mixture of the two 



26 INTRODUCTION. 

is necessarily inert. Thus the combination of belladonna 
and opium is in some degree opposed, atropia and prussic 
acid, aconite and digitalis, strychnia and Calabar bean, and, 
most markedly of all, caustic alkalies with belladonna, hy- 
oscyamus, stramonium, or tobacco, all of whose active 
principles are thus absolutely destroyed. 

But, as already hinted, we often prescribe an incom- 
patible mixture for the purpose of actually deriving thera- 
peutic advantage from the resulting compound. Thus 
what is a more generally used and, I may confidently say, 
\ more useful prescription than perchloride of mercury and 
iodide of potassium, making an iodide of mercury which 
is much more efficacious than that salt itself as prepared 
by more elaborate chemical agency? 1 Again, the far- 
famed mist, ferri co. derives much of its charm from the 
freshly prepared carbonate of iron which results from the 
due combination of ferri sulph. and pot. carb. Black 
wash is another example; and although corrosive subli- 
mate and decoction of bark are undoubtedly incompatible, 
no better means is known of counteracting the depressing 
effects of this preparation of mercury. 

9. Prescribing for Children. — A few words may now 
be said on the art of prescribing for children, a subject 
which is only incidentally touched upon in our ordinary 
books, and is then treated in a somewhat misleading man- 
ner. Elaborate tables have, however, been drawn up for 
the regulation of doses according to age, and in all of these 
it is assumed that young children necessarily require much 
smaller doses of most drugs than adults; and this is true in 
so far that it is seldom advisable to deal out our mixtures 
to them in the time-honored tablespoonful or two tablespoon- 
fuls of their elders. But the important fact which these 
systems invariably ignore is this, that children can often 
take, not only with impunity but even with decided benefit, 
quantities of active remedies which will correspond to a 
full adult dose. And the reason of this may be looked for 
in the much greater destruction and construction of tissue 

1 [Theoretically these salts in solution are chemically incompatible, 
as a reaction takes place, and a precipitate is formed. This precipitate, 
however, is soluble in an excess of iodide of potassium, forming an 
uncertain compound, which may be looked upon as a hydrargyro- 
potassic iodide, dissolved in a solution of potassic chloride, with 
other compounds not yet determined.] 



RULES FOR PRESCRIBING. 27 

in early life, whereby the organs of elimination are in 
unusual activity, and hence disposed to excrete medicinal 
substances with special promptitude. Whether we accept 
this explanation or not, however, I may warn the young 
practitioner that an adherence to the rules usually laid 
down for children's prescriptions will cause him serious 
disappointment, and that he will be surprised at the ben- 
eficial results which will follow the adoption of a bolder 
course [in special instances]. 

To furnish a few examples of this proposition, I will 
begin with belladonna, which may be used very freely 
in childhood, and the dose of which I have pushed in a v/ 
child of 10 suffering from incontinence of urine to f3ij- ! 
with good effect, and the development of only very mild 
forms of physiological disturbance. I commonly begin with 
nrxx. 1 in a child of 2 or 3, and have prescribed n^x. 1 in 
an infant of six months with remarkable benefit; and the 
result of my experience undoubtedly is, that children bear 
belladonna actually better than grown-up persons, and 
that in them really poisonous symptoms rarely if ever 
occur. I may add that this strange insusceptibility of chil- 
dren to belladonna was first pointed out by the late Dr. 
Fuller, and has since been abundantly confirmed by Dick- 
inson, Ringer, Kelly, and others. 

Arsenic may also be freely given to children, and, at the 
age of 5 or 6, I should have no hesitation in beginning with 
tt^v. [of Fowler's solution] and pushing even up to nrx. 
if necessary. Prussic acid [dilute] may be given in ny. 
to nyij. doses at the same age. Strychnia is also well 
borne. Tinct. ferri may be taken in large quantities, and I 
have seen excellent results follow the administration of f5j- 
ter die, in a little girl of 6. 

Children will often require large purgative doses, more 
especially of pulv. jalap, co., and of ipecacuanha as an 
emetic. I have often ordered quantities which have 
startled the dispenser and induced him to come for ex- 
planation under the idea that I had made a mistake. 
Bromide of potassium may also be freely given, and 
other instances will be noted as we go on, remembering 
always the sound old advice to be very careful with 
opium at an early period of life. Every practitioner has 

1 [British Pharmacopoeia.] 



28 INTRODUCTION. 

no doubt seen cases in which ill results have unexpectedly 
followed laudanum prescribed before the age of i year, 
and I cannot do more than reiterate the warnings on this 
subject which every manual of materia medica most pro- 
perly contains. Other points must also be attended to 
in prescribing for children. 

[A philosophical method of graduating doses for chil- 
dren has been proposed by Prof. Clarke. It is based 
upon the weight of the subject, the full, adult dose being 
considered as appropriate to a weight of one hundred and 
fifty pounds. The proportion of a full dose in each case 
would thus be represented by a fraction whose denom- 
inator should be 150 and the numerator the weight of the 
patient. Perhaps a more practical rule is this, proposed 
by Dr. Cowling. "The proportional dose for any age 
under adult life is represented by the number of the follow- 
ing birthday divided by twenty-four;" thus, for one year 
fz == T V; for five years & = J, etc.] 

It is always well to make our dose as small as possible, 
one or two teaspoonfuls being usually sufficient, and great 
pains must be taken, by means of well-adjusted flavoring 
ingredients, to disguise the too often nauseous taste of our 
drugs. Various syrups and aromatic waters here stand us 
in good stead, and it is well if possible, when dealing with 
very young infants, so to reduce the bulk of the medicine 
as to enable it to be mixed unobserved with milk, veal 
broth, beef-tea, or some sort of confection. In this there 
is nothing really antagonistic to the principle which has 
just been developed, as we can readily enough give con- 
siderable quantities of belladonna, arsenic, etc., in com- 
paratively small quantities of water, or even in none at all. 

Children are, however, somewhat strangely capricious 
in their taste; for whilst they object decidedly to bitter or 
acid substances, they will take oils readily, and generally 
seem to derive satisfaction from sucking in cod-liver oil. 
Nauseous powders which would seem inexpressibly revolt- 
ing to their elders, they often take well, and by a little 
contriving and consideration we can generally manage to 
persuade them to consume their dose with philosophic 
composure, if not with actual relish. 

10. Prescription Writing. — We next come to the con- 
struction, or what we may call the anatomy, of the pre- 
scription itself, how it is put together, and how its com- 



RULES FOR PRESCRIBING. 29 

ponent parts are arranged ; and we commence with the 
' R' with which it begins, and which really means an old 
invocation to Jupiter. But conventionally it has been 
held to imply the verb recipe, which governs the quantity 
in the accusative, the name of the medicine being put in 
the genitive. Thus, Recipe (take) pulveris (of powder) 
sca?n?nonice (of scammony) scrupiilum, &c. Other direc- 
tions are laid down in books which deal with this question, 
and much valuable information is contained in Pereira's 
' Selectae Praescriptis' and the clear and instructive little 
work of Dr. Griffith, of Dublin ; but it is hardly necessary 
to reproduce these here, as students beginning their medi- 
cal curriculum are presumably sufficiently well grounded 
in classics to enable them to understand the very moderate 
amount of Latin required for their use in prescribing. As 
a rule, medical men generally write their directions now- 
a-days in English ; and this has not only the advantage of 
limiting the chance of mistake, but it does away with much 
of that mystery which beyond anything else has tended to 
keep back the progress of our art. In these enlightened 
times, when even more than a smattering of physic is com- 
monly possessed by the laity, we do not find our patients 
quietly consenting to be kept in the dark as to what medi- 
cines they are taking. Rather we find them showing a keen 
interest in our prescriptions, anxious to enquire, and argue, 
and if possible understand, all about the line of treatment 
we have determined to pursue. The cases are very rare 
in which it is necessary to conceal from them the presence 
of any particular drug in their mixture, and Latin direc- 
tions are therefore not only unnecessary, but pedantic in 
the highest degree. It is still, however, the custom at 
the examining boards to ask the candidates either to write 
or read, or both, prescriptions fully constructed according 
to this custom, and in the prescriptions which we shall fre- 
quently add to our descriptions of the various drugs we 
shall invariably give the directions in Latin of the' usual 
form. 

11. Weights and Measures. — It only remains for us, 
then, to add the signs and symbols in general use, which 
are as follows : — 



3° 



INTRODUCTION. 



gr., granum . 
9, scrupulum (scruple) 
5, drachma (drachm) 
jf , uncia (ounce troy) 
lb., libra (pound) . 
tt^, minimum (minim) 
gtt., gutta (drop) 



= a grain. 
= 20 gr. 

= 3 scruples, or 6o grains. 
= 480 grains [or 8 drachms]. 
= 12 ounces troy [5760 grs.] 
= ^jth part of a fluid drachm, 
usually about ]/ 2 minim. 



[f3,fluidrachma(fluiddrachm)=- 60 minims.] 
[fj§, fluiduncia (fluid ounce) = 8 fluid drachms.] 
O, octarius (pint) . . = [16 fluid ounces, U. S. P.] 

20 oz. [Imperial measure] 
C, congius (gallon) . = [8 pints.] 

In the British Pharmacopoeia the time-honored drachm 
and scruple weights have been discarded, and all who 
prescribe or dispense medicines are recommended to dis- 
continue their use ; but old fashioned customs are not so 
readily swept away, and we accordingly find these most 
convenient terms flourishing as much as ever. In domes- 
tic practice we find a much more rough and ready mode 
of prescribing, the generally received measurements being 
as follows : — 



Teaspoonful . 

Desertspoonful 

Tablespoonful 

Wineglassful . 

Teacupful 

Breakfast-cupful 

Tumbler 



= 1 fluid drachm. 

= 2 fluid drachms. 

= 4 fluid drachms. 

= \y 2 to 2 fluid ounces. 

= 5 fluid ounces. 

= 8 fluid ounces. 

= 10 to 12 fluid ounces. 



Of all domestic modes of measurement, however, none 
can equal the drop in fallacy and danger. The size of a 
drop is influenced first by the shape of the bottle, and 
secondly by the quality of the fluid itself, and hardly two 
substances will be found to contain the same number of 
drops in a given quantity. 

Tablespoons, teaspoons, and all domestic measures are 
most absurdly variable in size, and we shall do well steadily 
to discountenance their use in all cases, and to insist that 
our patient shall carefully regulate his dose by means of 
those graduated glasses which are within the reach of all 
but the very poorest. 

12. Observations upon Doses. — Now, although it 
would manifestly be lulling our readers into a false secu- 



RULES FOR PRESCRIBING. 31 

rity, were we to attempt to lay down any absolute rules 
respecting dosage, we may venture to state some broad 
principles which will help the memory. Students often 
complain of the great difficulty they experience in remem- 
bering doses, and at first sight it would appear a most 
irksome task for a person not in the habit of prescribing 
to carry in his mind the major and minor quantities of 
drugs which he may safely order. But by giving a few 
rules, and adding exceptions, as in the Latin grammar, we 
hope to show that there is no real difficulty here, but that 
we may safely group substances in such a way as to asso- 
ciate their doses with one another with tolerable simplicity. 
But first let me say one word about the British Pharma- 
copoeia. Constructed as it was by official authority several 
years ago, it is naturally looked upon as our vade meatm, 
and every student is supposed to possess a copy and to 
make himself familiar with its contents. Now, in the first 
edition no doses were given, and in the next, although 
these were added in deference to a universal request, it 
was expressly stated that they were not to be considered 
authoritative, or specially enforced by the Medical Council. 
But the Pharmacopoeia, being the only official guide, has 
now been forced into a position respecting dosage which 
it did not intend or desire, and we therefore find that in 
any case of difficulty its authority is invariably appealed 
to. It lies on every druggist's counter, it is the standard 
in courts of justice, and, this being the case, it ought to 
reflect the most advanced researches on its subject. But 
this is not so; on many points its recommendations are 
hopelessly at variance with modern practice, and we are 
hence exposed to the annoyance and possible discredit of 
having our prescription sent back or cut down by druggists 
who are afraid of exceeding the dose sanctioned by au- 
thority. Thus the maximum dose of succus conii is fixed 
by the Pharmacopoeia at f3j., of quinine at gr. x., digitalis 
f 5j- ; and when we come to consider the various substances 
in succession, we shall find many other examples of a dis- 
crepancy between my teaching and its statements, which 
this explanation will clear up. [These difficulties are 
happily avoided by the United States Pharmacopoeia, the 
doses of remedies being judiciously omitted.] 

13. General Rule for Doses. — We may now proceed 
to indicate the natural system of grouping, by which some 



32 INTRODUCTION. 

order may be given to the arrangement of the doses of 
drugs in the already crowded brain of the student or the 
young practitioner. 

Thus let him remember that, as a general rule, tinctures 
may be prescribed in doses of from f^ss. to f3ij., infusions 
and decoctions from f^ss. to f^ij., powders from two to ten 
grains, pills four to ten grains; and although there are 
numerous and very important exceptions to this, the recol- 
lection of the principle will spare us from the drudgery of 
placing the exact dose after every preparation whose action 
we shall examine. 

[The following are the important exceptions to this rule, 
the dose of each of which should be learned separately. 

Tinctura aconiti radicis, U. S. P. Tinctura nucis vomicae, U. S. P. 

" belladonnse, " " opii, " 

" cannabis, " " " acetata, " 

" cantharidis, " " " deodorata, " 

" colchici, " " scillae, " 

" conii, " " stramonii, " 

" digitalis, " " veratri viridis, " 

" ferri chloridi, " Infusum digitalis," " 

" hyoscyami,"* " " capsici, " 

" iodinii, " " tabaci, " ] 

" ioctinii composita, " 

These rules may be borne in mind in a general way, and 
we shall now go on to consider very briefly the plan of 
arrangement to be pursued when we come to consider the 
various medicinal substances seriatim. 



Our object will be to balance, as far as possible, their 
physiological against their therapeutical action, arranging 
them in corresponding columns in diagrammatic form ; and 
it will greatly assist this arrangement, as well as aid the 
memory of the student, if we adopt the following order 
in stating what we know respecting the properties of each 
drug. 

Take, first, its local or external action. 

Then its influence on the brain and on the spinal and 
sympathetic system of nerves. 

This will lead us up gradually to the effects on the heart 
and bloodvessels, whose functions are presided over, and 
ruled bv, nervous influence. 



GENERAL PLAN OF ARRANGEMENT. 33 

The effects of the drug on respiration and temperature 
will next be considered, and we then proceed to the alte- 
rations of secretion in the following order: urinary, intes- 
tinal, salivary, cutaneous, &c. 9 

Then other actions which come under no heading, and 
which may be called specific. 

Finally, we must consider the various modes of elimi- 
nation from the body, the antidotes, contra-indications, 
and best modes of prescribing, winding up, in most cases, 
with a prescription which will, as far as possible, combine 
efficiency and elegance with palatability. 

It will of course often happen that we cannot accurately 
balance the physiological against the therapeutical action 
of a drug, either from want of sufficient knowledge or 
from an excess of facts of more or less conflicting nature. 
We must remember that our therapeutical evidence is de- 
rived from clinical observation on man, and that experiment 
on the lower animals has supplied us with most of our 
knowledge respecting the action of medicinal agents on 
the healthy organism. Fallacies may readily creep into 
both these methods of investigation, and it is evident how 
the clinical method may be hampered by our want of full 
knowledge of the natural history of disease. Although 
late years have done a good deal in showing how various 
acute maladies behave, when uncomplicated in their course, 
by active medication, we are still much in the dark, and 
too prone to confuse the propter with the post. And the 
results of the very elaborate system of experimentation 
which has lately been carried on in Germany and else- 
where cannot be accepted as fully conclusive of the physio- 
logical action of the various drugs on man. One source 
of fallacy undoubtedly lies in the very differing suscepti- 
bility of certain members of the brute creation to certain 
drugs. Thus rabbits freely digest belladonna as well as 
opium ; it is difficult to poison pigeons with strychnia, or 
fowls with prussic acid ; and other instances of this curious 
law have been placed on record. It is therefore reason- 
able to suppose that the special structure and habits of the 
lower animals exercise an equally modifying influence with 
regard to the special action of medicinal substances on 
special organs and functions, so that we must be prepared 
to receive some facts drawn from this source with a certain 
amount of reserve. In addition to this, the shock and 



34 INTRODUCTION. 

general damage inflicted on the victims of experiment by 
the necessary manipulations must frequently alter so 
seriously the conditions of secretion as to render any 
deductions on this score very inconclusive; whilst, finally, 
it is well known that drugs which appear to have no action 
on a special organ whilst in health may very materially 
modify its condition when congestion or any other form 
of morbid action has set in. In looking over, therefore, 
the large mass of evidence furnished by the industry of 
able physiologists, we cannot fail to be struck by the dis- 
crepancy which exists occasionally between the results 
obtained. Different observers experimenting in different 
ways now and. then get different results, and in no case has 
this been more distinctly shown than by the way in which 
the labors of the celebrated Edinburgh Committee have 
been practically set aside by later investigators, who have 
shown that mercurials, as well as other drugs, actually do 
increase the biliary secretion. We must therefore bear all 
this in mind, and endeavor so to sift all our evidence as 
to place on our tables only that which the opinion of our 
best authorities has thoroughly and fully endorsed. 

Regarding the method in which the following pages will 
be arranged, a few words may be said. 

Different modes of grouping drugs have been adopted, 
and by some the preference is given to the purely physio- 
logical plan, by which all the medical substances having a 
particular action are placed under that special heading ; 
thus we have purgatives, narcotics, astringents, etc., as 
different varieties, with their attendant species. No doubt 
such a plan has the merit of scientific precision, and, had 
each drug only one medicinal action, nothing could be 
simpler or more effective than this arrangement, of which 
Neligan is the chief exponent. But an unfortunate ele- 
ment of complication is introduced by the fact that one 
drug may act in many and indeed opposing ways. Thus, 
whilst opium is an astringent, it has every right, under 
certain circumstances, to be called a purgative ; its stimu- 
lant action is as evident as its narcotic; it is a diaphoretic, 
a sedative, an antiphlogistic; and the confusion inseparable 
from hunting it about among its various headings must 
necessarily be perplexing to the mind of the student, as 
well as occasion loss of time. Many other drugs behave 
in the same way; so it has been thought best to adopt the 



GENERAL PLAN OF ARRANGEMENT. 35 

arrangement of Garrod and other popular text-books, in 
which the inorganic substances are placed alphabetically, 
and the organic in accordance with the natural orders to 
which they belong. We shall only venture to make one 
modification, and that will be to remove the. general prin- 
ciples of therapeutics from its usual position at the end of 
the book, and scatter its classification systematically through 
our pages. For instance, after treating of the leading 
member of the purgative or narcotic group, we shall use 
that as a peg on which to hang a general description of 
that class of substances in general, and in this way we 
may hope to relieve that tedium which is apt to arise when 
too many deductions and generalizations are presented en 
masse. 



[In preparing an American edition it has been deemed 
advisable to adhere strictly to the alphabetical arrange- 
ment just mentioned. In the following pages, every 
remedy included in the Primary List of the Materia Medica 
of the United States Pharmacopoeia is presented in regular 
order, new titles being introduced when necessary in order 
to make the list complete. When botanical or chemical 
definitions are given in the Pharmacopoeia, they also are 
herein reproduced, the customary doses affixed to remedies 
adapted to internal use, and, wherever practicable, the 
composition and strength of the officinal preparations are 
also indicated. Some prominent remedies of the U. S. 
Secondary List, with others not yet officinal, are arranged 
in like manner in a separate section. In order to render 
the plan of the work more harmonious and consistent, and 
add to its essentially practical character, it has been con- 
sidered proper to collect together the scattered paragraphs 
upon the principles of therapeutics and to group them to- 
gether, devoting a special chapter to their consideration 
under the title of Remarks on Certain Classes of Reme- 
dies.] 



REMARKS 



ON 



CERTAIN CLASSES OF REMEDIES. 



ANTIDOTES. 



The first thing to be done 
in any case of poisoning is 
to empty the stomach, and to 
eliminate the poisonous sub- 
stance from the tissues. 



The next stage in our pro- 
ceedings must be to obviate 
the tendency to death, ac- 
cording to the various vital 
processes attacked by the 
poison. 
4 



This may be effected in 
the first place by emetics, 
and more especially those of 
the direct class ; but it will 
often happen, particularly^ 
in narcotic poisoning, that 
emetics will not act, and that 
we are forced to have re- 
course to the stomach-pump. 
Caution in the use of this 
instrument, however, is re- 
quisite in cases of irritant 
poisoning in which the mu- 
cous membrane of the sto- 
mach is softened or partially 
destroyed. When evacua- 
tion of the stomach has been 
completed, we may employ 
gentle purgatives and diure- 
tics in addition to such reme- 
dies as iodide of potassium 
which favor the elimination 
of metallic substances. 

Thus, if cardiac syncope 
be the main symptom, we 
must give stimulants ; if the 
respiratory centre seems in 
danger of becoming para- 
lyzed, we must excite respi- 

(37) 



3» 



ACIDS 



Having got so far, we must 
then proceed to use our anti- 
dotes proper, which may be 
divided into (i) Chemical, 
which directly neutralize the 
action of the poison by de- 
stroying its properties; and 
(2) Physiological, which 
have distinctly antagonistic 
properties, being, indeed, in 
many cases, absolute coun- 
ter-poisons. 



ratory action by cold affu- 
sion, irritation of the skin, 
and the employment of arti- 
ficial respiration, and give 
atropia, which stimulates the 
origin of the pneumogastric 
nerve in the medulla; if nar- 
cosis prevail, we must endea- 
vor to rouse the brain ; and 
if irritation of any particular 
organ arises, we must soothe 
it by appropriate remedies. 

1. Among the first class 
we may rank alkalies in acid 
poisoning, animal charcoal 
as rendering the vegetable 
alkaloids innocuous, and li- 
quor potassae as depriving 
belladonna and its conge- 
ners of all physiological 
power. 

2. The second contains 
all those various substances 
which have been described 
here and there in these pages 
as directly antagonistic to 
one another, as opium within 
certain limits to belladonna, 
Calabar bean to atropia and 
strychnia, aconite to digi- 
talis ; and this class, of anti- 
dotes has the advantage over 
the more purely local or 
chemical, that they are able 
to pursue their foe into the 
blood, and attack it boldly 
and successfully there. 



ACIDS. 

We next come to the consideration of acids, and, before 
enumerating the therapeutic properties of each individual 
member of the group, it will save time and repetition if we 



ACIDS. 



39 



draw attention to the collective actions and uses of acids in 
general. 

External Action. 



Physiological. 

Acids, being possessed of 
high diffusive power, rapidly 
permeate tissues to which 
they may be applied, coag- 
ulate their albumen, and, if 
concentrated, absorb their 
watery constituents and 
cause their destruction. 



Therapeutical. 

Acids, if used in concen- 
trated form, therefore, act as 
caustics, eating away and 
destroying animal tissues. 
When more diluted they are 
astringents, hardening and 
constringing weakened parts 
and checking unhealthy se- 
cretions. 



Internal Action. 



i. On Circulation. — It is 
stated that phosphoric and 
acetic acids diminish the 
force and frequency of the 
pulse, and reduce the num- 
ber of blood corpuscles. 

All the acids, however, 
have the property of increas- 
ing the acidity of the blood, 
probably rather by setting 
free another acid than by a 
direct action on that fluid ; 
for by the time they enter 
the circulation they are 
themselves converted in 
great measure into salts by 
the various alkaline secre- 
tions with which they have 
come in contact. 

They may also contract 
the smaller blood-vessels by 
reflex action, or by directly 
astringing them locally. 

2. No special effects on the 
respiration or nervous system 
have been noted, but phos- 



The action of acids in 
checking hemorrhage is thus 
explained, as there is no 
doubt that coagulation [of 
fibrin in the vessels is pre- 
vented, and its fluid condi- 
tion normally maintained 
and] encouraged by an alka- 
line condition of the blood. 



They are useful in inter- 
nal hemorrhage, and to 
check excessive perspira- 
tion. 



4o 



ACIDS, 



phoric and acetic acids are 
said slightly to lower the 
temperature. 

3. Their action on secre- 
tion is interesting, and has 
been specially pointed out 
by Ringer. It appears that 
an acid applied to the orifice 
of a gland secreting an acid 
fluid will check that secre- 
tion, and thus any member 
of this group taken into the 
stomach before or at the be- 
ginning of the process of di- 
gestion will tend to act un- 
favorably by stopping the 
flow of gastric juice. 



This physiological action 
points to a valuable bearing 
on therapeutics. Some cases 
of dyspepsia depend on a de- 
ficient production of gastric 
juice, enough of this fluid 
not being secreted under the 
stimulus of food to dissolve 
and digest the albuminous 
constituents. This condition 
may be remedied by me- 
chanically supplying the 
want by a little acid given 
some time after food. But 
again, still more cases of dis- 
ordered digestion are caused 
by an excessive formation of 
gastric juice, the surplus sup- 
ply of acid teasing and wor- 
rying the mucous membrane 
of the stomach, and causing 
pain, sour eructations, and 
general distress. Here our 
physiological law comesinto 
play, and we check the over- 
secretion by giving the acid 
immediately before the meal. 
Or again, discomfort may 
result from irregular or ex- 
cessive fermentation of food 
giving rise to the formation 
of a large quantity of acetic, 
butyric, and lactic acids ; 
and this undue fermentation 
is found to be itself directly 
controlled by acids given in 
this case after food. Possi- 
bly some of their influence 
in checking acid perspira- 
tion may be due to this law. 



ACIDS. 



41 



But if acids arrest secre- 
tions having their own 
chemical reaction, they 
stimulate those which are 
alkaline, markedly increas- 
ing their quantity. 



4. On the Urine. — Acids 
increase somewhat the acid- 
ity of the normal urine, but 
have no power of rendering 
an alkaline urine acid. This 
property is alone possessed 
by benzoic and citric acids, 
which are not true acids in 
the chemical sense. 

Acids, by their astringent 
properties, brace up relaxed 
mucous membranes, and 
check unhealthy secretion. 



We can thus explain what 
has been called the refriger- 
ant action of acids, or their 
undoubted influence in re- 
lieving thirst and imparting 
a fictitious sensation of cool- 
ness. By stimulating the 
secretion of the salivary 
glands, we moisten the dry 
parched mouth of our fever 
patient, and quench his 
thirst perhaps better than in 
any other way. 

It is probable also that 
some at least of the benefi- 
cial influence exerted by 
acids on chronic biliary de- 
rangement is due to their 
directly increasing the flow 
of alkaline fluid from the 
liver. 



They are therefore good 
tonics, and act well in diar- 
rhoea and profuse sweating. 



Disadvantages. 

The prolonged use of acids is apt to exercise a very un- 
favorable influence on digestion, rendering persons pale 
and languid, and causing a good deal of emaciation ; and 
this was no doubt the secret of the action of vinegar in 
reducing corpulence, which used to be so highly prized 
in the Byronic days, and by incautious indulgence in which 



42 ANTHELMINTICS. 

so many ignorant people have at various times ruined their 
health. 

Poisonous Effects. 

The symptoms consist of very violent burning pain in 
the stomach and intestines, vomiting, purging, intense 
prostration, and death either by shock or by the results of 
secondary inflammation. On post-mortem examination, 
intense inflammation of the stomach and intestines is found, 
with ulceration of the mucous membrane, and even per- 
foration into the peritoneal cavity ; and if the case is of a 
more lingering character, fatty degeneration of various 
internal organs, but more especially the kidneys, becomes 
gradually developed. 

ANTHELMINTICS. 

The human body being infested with various parasites 
whose presence is inconvenient and even dangerous, it is 
necessary for us to be provided with means for their safe 
and speedy removal. Some of these unwelcome guests 
are, unfortunately, out of the range of medicine, but 
others are so placed that they can readily be destroyed ; 
and we shall arrange them in classes, according to the 
special drugs which act specially upon them. 

i. Tape-worms, as the i. The best remedy for 
taenia solium, derived from the taeniae is now allowed to 
eating measly pork ; the be male-fern oil given on an 
taenia medio-canellata, from empty stomach; but if this 
veal or beef ; and the taenia should possibly fail, we may 
lata, from salmon. These have recourse to kousso, tur- 
occupy the small intestines, pentine, pomegranate root, 
and give rise to various ill- or areca nut. 
defined but uncomfortable We must remember that, 
sensations. although these remedies kill 

the worms, they do not 
necessarily expel them from 
the intestines, and that a 
purgative may be required 
for this purpose ; and it is 
also essential to find the 
head of the tape- worm be- 



ANTHELMINTICS. 



43 



2. The round-worm, or 
ascaris lumbricoides, in- 
habiting the small intestine, 
and occasioning a long array 
of nervous symptoms, more 
especially in children. They 
are supposed to be intro- 
duced into the system by 
impure water. 

3. The thread-worm, or 
oxyuris vermicularis, 
found in the caecum or 
colon, and causing much 
itching and irritation. They 
are almost universal among 
the children of the poor, 
but opinions differ as to 
whether they must be re- 
garded as the cause or the 
effect of the peculiarly ca- 
chectic condition with which 
their presence so often 
coincides. 

Other forms of parasitic 
intrusion within the various 
tissues are well known, but 
are generally incurable ; and 
the trichina spiralis, the vari- 
ous forms of hydatid dis- 
ease, &c, must usually be 
permitted to run their de- 
structive course unchecked. 



fore we can assure our pa- 
tient that he is freed from 
his tormentor. 

2. Santonin acts as a true 
specific in at once destroy- 
ing these troublesome para- 
sites. 



3. It would seem rather 
a roundabout practice to at- 
tack parasites in the lower 
gut by drugs administered 
through the mouth ; and 
although purgatives, such as 
scammony, calomel, jalap, 
&c. , are of use in these cases, 
our chief reliance must be 
placed on enemata of quas- 
sia, tincture of iron, lime- 
water, common salt, &c. 

In the general treatment 
of parasites, we must not 
trust entirely, however, to 
the use of anthelmintics, but 
must also exclude all possi- 
bility of infection by forbid- 
ding raw or underdone meat 
or fish, and by insuring 
general cleanliness and an 
efficient water-supply. In 
addition to this, we must 
remedy the unhealthy con- 
dition of mucous membrane, 
which favors their develop- 
ment, by giving alkaline re- 
medies and bitter tonics in 
various forms of combina- 
tion. 



44 



ANTIPYRETICS AND REFRIGERANTS. 



In prescribing our remedies for the expulsion of the 
tape-worm, it is well to insure a thorough evacuation of 
the intestines, so that the parasite may not be in any way 
shielded from the action of the drug by food or mucus. 
After a preliminary purge, we direct our patient to fast 
for a few hours, and then administer the fern oil in milk, 
either at bed-time or in early morning. 



ANTIPYRETICS AND REFRIGERANTS. 

Antipyretics. 



Antipyretics are remedies 
which reduce the bodily tem- 
perature, some acting only 
against the preternatural 
heat of febrile conditions, 
whilst others can also cool 
down the natural warmth 
below the normal standard. 
We may thus divide their 
action : — 



Class i. Those which act 
by directly cooling the sur- 
face of the body by local 
application. 



Class 2. Those which act 
by internal administration, 
either lessening oxidation, 



In this country we are not 
much in the habit of regard- 
ing the temperature, per se, 
as a special element of dan- 
ger, unless it goes beyond a 
certain height, and we there- 
fore do not, as a rule, treat 
this symptom very energeti- 
cally. Foreign experience 
seems to show that, although 
we may reduce the actual 
heat in acute disease, we do 
not necessarily alter the 
course of the attack, and we 
therefore usually confine our 
efforts to supporting our pa- 
tient and looking out for 
complications. On the other 
hand, however, when the 
thermometer registers 105 °, 
and still tends upwards, we 
are bound to interfere. 

1. This is undoubtedly 
our most effectual antipyretic 
means, and may be carried 
out by cold affusion, wet 
pack, or, best of all, by the 
carefully graduated cold 
bath. 

2. This class consists of 
the antipyretic drugs, pro- 
perly so called, such as qui- 



ANTISEPTICS AND DISINFECTANTS 



45 



or exerting some special in- 
fluence on the nervous sys- 
tem. 



Class 3. Those which act 
by dilating the superficial 
vessels and enabling a larger 
sheet of blood to be spread 
over the cutaneous surface, 
and thus brought in contact 
with the cooling influence of 
the air. The chilling effect 
then produced by the return 
of the circulating fluid to the 
heated centres, although 
very transient, may become 
considerable by repetition. 

Class 4. Remedies which 
act by bracing up and 
strengthening the nervous 
system, and removing some 
of that enfeebled and semi- 
paralyzed condition on 
which febrile temperatures 
have been supposed to de- 
pend. 



nine, digitalis, veratria, al- 
cohol, salicylic acid, &c. ; 
but, with the exception of the 
last-named, they are not 
much used for this purpose. 
3. Under this heading we 
must include the whole class 
of diaphoretics, as well as 
chloral hydrate, the warm 
and Turkish bath, &c. 



4. A rising temperature 
being often an indication of 
debility, we may then check 
it by tonics, good food, 
small doses of alcohol, &c. 



Refrigerants. 

Refrigerants, of course, necessarily include all remedies 
which actually lower the bodily temperature, but the con- 
ventionally accepted meaning of the term merely implies 
anything which alleviates thirst. Thus we find that the 
mere sipping of any fluid moistens the dry tongue and 
lessens the thirst of fever, whilst acids, by stimulating the 
secretion of saliva, may fulfil the same indication in a 
more scientific and effectual way. 



ANTISEPTICS AND DISINFECTANTS. 

Dr. Parkes proposed that the term disinfectant should 
be restricted to those substances which arrest the spread of 
specific disease depending on the entrace into the body of 



46 ANTISEPTICS AND DISINFECTANTS. 

a special agent ab externo, and that agents acting in other 
ways should be called air purifiers and sewage deodorants. 
It would seem well, however, to adhere in these pages to 
the nomenclature most commonly in use in our received 
text-books of Materia Medica, and, whilst willingly con- 
ceding the palm of scientific precision to Professor Parkes, 
I shall adopt the following division of the subject into dis- 
infectants and antiseptics. 

Disinfectants are those substances which act by destroy ■ 
ing offensive animal or vegetable effluences, arresting 
putrefaction, and stopping the spread of infectious and 
epidemic disease by destroying the particles on which the 
poison of these diseases is supposed to depend. How they 
do this is not matter of absolute certainty, but they act in 
many cases by direct chemical agency, by deoxidising, or 
by taking up hydrogen and water ; and the theory of the 
modus operandi of various substances here enumerated will 
be considered when each of them comes separately under 
review. Adopting, then, in some measure the nomencla- 
ture of Parkes, disinfectants may be divided into 

i. Air purifiers, which we may again subdivide into — 
(i) Solid air purifiers, of which charcoal is the best, also 
dried earth, quick lime, &c. 

(2) Liquid air purifiers ; Condy's fluid, zinc chloride, 
lead nitrate, and, 

(3) Gaseous air purifiers ; such as zinc, chlorine, iodine, 
bromine, nitrous acid, sulphurous acid, and carbolic acid. 

2. We may next include the sewage deodorants, of 
which charcoal, dry earth, as in Moule's patent system, 
iron perchloride, quick lime, potassic permanganate, car- 
bolic acid, with the various powders, such as M'Dougall's 
and Calvert's, which are prepared from it, are the most 
prominent. 

3. Finally we have what Dr. Parkes calls disinfectants 
proper, which arrest contagious disease by destroying the 
particles of matter which pass away from the bodies of the 
sick. Of these heat is a valuable member, it being now 
well known that a dry heat, as of an oven, at over 212 
will completely disinfect clothes. 

Chlorine is effectual, but irritating ; nitrous acid vapor 
has been recommended, carbolic acid is of undoubted 
service, but sulphate of iron seems to be of very doubtful 
utility. 



COUNTER-IRRITANTS. 47 

Antiseptics are those substances which arrest the spread 
of disease and decomposition generally, not by chemical 
action, but by a poisonous effect on the minute animal or 
vegetable germs on which these processes depend. It is 
therefore clear that they dovetail very essentially with the 
preceding group, more especially as it is difficult to draw 
a hard and fast line between those disinfectants which act 
chemically and those which arrest putrefaction and infec- 
tive processes in other ways. The term antiseptic, there- 
fore, is superfluous, and would probably have dropped 
altogether out of use had it not been for the term antisep- 
tic surgery, which has been so extensively employed by 
Mr. Lister and his school, the theory being that putrefac- 
tion and pyaemia depend upon the presence of innumerable 
germs from which these substances free the air. 

The principal are carbolic acid, zinc chloride, boracic 
acid, salicylic acid, sulphurous acid, corrosive sublimate, 
and perchloride of iron. 

The term parasiticide has also been employed as indi- 
cating those substances which specially act as poisons to 
the minuter animal or vegetable life, and are used medi- 
cinally with this view. Thus sulphurous acid and per- 
chloride of mercury are used with success as local appli- 
cations in various forms of parasitic skin disease, and sul- 
phurous acid is beneficial in those classes of vomiting 
which depend on the irritation of low forms of crypto- 
gamic vegetation imbedded in the mucous glands of the 
stomach. 



COUNTER-IRRITANTS. 

The theory of the action of epispastics and rubefacients 
has given rise to much interesting physiological spec- 
ulation, but we are not yet able to lay down, with absolute 
precision, the laws on which the beneficial action of these 
remedial agents depends. We know this much, however, 
that blisters may occasionally act locally on deeper seated 
parts, as we are told that redness and inflammation of pleura 
and peritoneum may be produced by the vesicating influ- 
ence of cantharides applied to the cutaneous surface super- 
ficial to these structures. 

Then, again, vascular connection may explain other 
phenomena, and more especially may this be traced in the 



48 DIAPHORETICS. 

chest between the pericardial vessels and those of the skin 
immediately over the heart, and in the lumbar region 
between the superficial vascular supply and that which 
furnishes to the kidneys their due allowance of arterial 
blood. 

These more direct and obvious explanations of various 
interesting therapeutical phenomena do not, however, 
lead us very far, and we are compelled to fall back upon 
much more abstruse considerations. Into these neither 
our space nor the scope of the present volume will permit 
us to enter very far, and we only very briefly draw a slight 
outline of those branches of the question which seem to 
have reached something of vigorous growth. 

Now for the relief of pain, counter-irritation may act, 
ist, by removing or modifying the structural condition on 
which the reflected suffering depends, as we often cure a 
facial neuralgia by extracting a carious tooth ; or 2nd, the 
end organs of the sensory nerves may be modified in mole- 
cular arrangement ; or 3rd, the trunks of the nerves them- 
selves, or the nuclei or the nervous centres, may be altered 
in some unexplained way by the stimulus applied to the 
seat of pain. 

For other purposes, also, counter-irritation may act by 
altering or redistributing blood supply, as by actually emp- 
tying the deeper vessels and filling the more superficial arte- 
rioles at their expense ; or special function or nutrition 
may be profoundly affected by influencing the trophic or 
other nerves which more especially preside over these 
departments of physiology. 

The practical applications of counter-irritation in the 
treatment of disease are both numerous and interesting; 
but when considering iodine, mustard, and cantharides, 
we have already devoted some space to the consideration 
of the principles which should guide us to their successful 
use. 

DIAPHORETICS. 

This class of remedies has Diaphoretics are used 

the property of increasing freely in practice at the out- 

the secretions of the skin, set of acule diseases, to relax 

and is usually divided into the contracted vessels and 

(1) the stimulating and (2) relieve the hot dry skin, and 



DIAPHORETICS. 



49 



the sedative. Under the 
first heading we include 
those drugs which stimulate 
the cutaneous circulation, 
among the principal of 
which are ammonia, alco- 
hol, the cold bath, phos- 
phorus, &c. ; and, second- 
ly, we speak of the sedative 
class, which act by dilating 
the superficial vessels, these 
being ipecacuanha, tartar 
emetic, jaborandi, aconite, 
the warm bath, and all the 
nauseating and emetic sub- 
stances, the depressing ac- 
tion of which is invariably 
attended by free perspira- 
tion. Then again we must 
refer to what are known as 
adjuvant remedies, such as 
warmth to the surface, 
diluent drinks, &c. 



in pneumonia this line of 
treatment has produced 
good results. The sedative 
class would seem to be best 
adapted for this purpose ; 
but the cold bath, which 
more naturally belongs to 
No. i, has been freely used 
abroad in febrile disorders, 
and part of its beneficial 
effects must no doubt be due 
to its action on the skin. 

In eruptive fevers, when 
the eruption is not sufficient- 
ly developed, we endeavor 
to excite the function of the 
skin, and thus favor the 
local manifestation of the 
poison, by warm baths, cold 
packing, and possibly by 
phosphorus. We also use 
diaphoretics to favor absorp- 
tion, as in various dropsies, 
and to relieve the kidneys, 
between which and the skin 
so much sympathy exists. 

They are also of service 
by assisting to eliminate 
morbid products from the 
blood. When the various 
internal organs, whose duty 
it is to get rid of certain 
effete and hurtful matters, 
are temporarily or perma- 
nently off work, we may 
hope to supply their place 
in some measure by the skin, 
and in Bright' s disease we 
may thus relieve the system 
of some urea, in jaundice of 
biliary products, &c. 



5° 



DIURETICS 



DIURETICS. 

Diuretics stimulate and increase the flow of watery fluid 
through the kidneys in various ways, which we may con- 
veniently classify under the following headings : — 



Class i. Stimulating diu- 
retics, which act by directly 
exciting or irritating the 
glandular secreting struc- 
tures of the kidney. 



Class 2. Those drugs 
which stimulate the circu- 
lation, causing increased 
arterial tension, and thus 
greater pressure on the walls 
of the Malpighian bodies, 
by which means transuda- 
tion of watery fluid is me- 
chanically favored. 

Class 3. We next come to 
the saline diuretics, which, 
in addition to some slightly 
stimulating influence, have 
a special power of absorbing 
and holding watery fluids, 
which they then carry with 
them in their exit from the 
body. 

Class 4. Mechanical diu- 
retics must next be included 
in the list, and among the 
principal of these we may 
mention water, which acts 
by washing the urinary 
tubules clear from epithe- 
lium or casts, which block 
them under certain condi- 



1. These are cantharides, 
turpentine, colchicum, &c, 
and they are rarely used, as 
they are liable to produce 
pain, strangury, and even 
haemorrhage. Cantharides 
has, however, been recom- 
mended in some forms of 
chronic albuminuria and in 
pyelitis. 

2. The principal of these 
are digitalis, belladonna, 
squill, and ergot ; and they 
are of service in various 
dropsies, and perhaps most 
especially in those which 
depend on disease of the 
heart. 

3. In this group we in- 
clude the lithia, potash, and 
soda salts, and most of them 
possess a double action, 
being diuretic in small, and 
purgative in large doses. 
They are also used with ad- 
vantage in anasarca and 
dropsical accumulations. 

4. Dr. Dickinson has 
shown how well copious 
draughts of water act in the 
acute desquamative nephri- 
tis of children, on the mere 
mechanical principle of 
sluicing or washing out the 
obstructed tubules. The 
indirect diuretics are often 



EMETICS. 51 

tions, and so allowing secre- of most service in renal 
tion to be re-established, disease. 
Under this heading we may 
also group those remedial 
means which act indirectly 
by relieving the kidneys in 
various ways. Thus, when 
congestion is present, local 
bleeding, dry cupping, 
warm fomentation, &c, 
may be the best diuretics. 
When the kidneys are 
pressed upon by ascitic fluid, 
a renewal of their full func- 
tion frequently follows the 
operation of tapping, and in 
many cases we may give 
these organs temporary rest 
by handing some part of 
their duties over to the skin 
or the bowels. 

Diuretics are notoriously uncertain remedies, and many 
of them have not the slightest power of increasing the flow 
of urinary water during health. They also vary much in 
their power of promoting the elimination of urea and other 
products of excretion by the kidneys. They may be given 
either by the mouth or by vapor, in which way oil of juni- 
per acts well ; or, as in the case of digitalis, they may be 
efficiently used by cutaneous absorption. In their admin- 
istration we must observe the following rules. Give them 
freely diluted, and, as a rule, combined with one another, 
as several remedies of the class seem to act better than one, 
as in the famous Guy's pill. Keep the patient cool, so as 
to avoid any action on the skin, and endeavor to prevent 
the bowels from coming too freely into play. 

EMETICS. 

The object of an emetic is to stimulate the so-called 
vomiting centre in the medulla oblongata, close to the 
origin of the pneumogastric nerve, and induce it to call 
forth the complicated series of muscular acts which termi-' 



52 



EMETICS 



nates in evacuation of the stomach. Emetics act in two 
ways, and are thus classed, as : 



Direct. 

Where the drug irritates 
the filaments of the pneumo- 
gastric nerve distributed to 
the mucous membrane of 
the stomach, and this irrita- 
tion, being transmitted to 
the centre, is reflected in 
motor impulses through the 
pneumogastric, phrenic, and 
intercostal nerves. The 
direct emetics are prompt 
in their action, and cause 
little nausea and depression ; 
and the principal members 
are sulphate of zinc, sulphate 
of copper, carbonate of 
ammonia, mustard, common 
salt, &c. 



The reflex chain then being established by which the 
muscular apparatus causes vomiting, we must next con- 
sider the various steps of the process. 



Indirect. 

Emetics of this class are 
conveyed directly by the 
medium of the blood to the 
vomiting centre, and act 
well by injection without 
coming into contact with 
the stomach. They are less 
prompt and more depressing 
than those of the other class. 
Principal members : Ipecac- 
uanha, tartarized antimony, 
apomorphia, veratria, del- 
phinia, &c. 



Physiology of Vomiting. 

i. In the first place the 
cardiac sphincter must be 
relaxed, or no vomiting can 
take place, and the persist- 
ent contraction of this struc- 
ture may account for many 
cases of distressing retching. 

2. The actual contraction 
of the walls of the stomach 
itself must be supplemented 
by that of the abdominal 
parietes. 

3. The diaphragm de- 
scends and becomes fixed. 



Therapeutics. 

Emetics are used to empty 
the stomach in cases of 
poisoning, and here we in- 
variably employ the direct 
class, such as sulphate of 
zinc, mustard, salt, &c. 

They are also of service in 
some forms of dyspepsia and 
to clear the stomach in in- 
toxication, and for the relief 
of the convulsions of infancy, 
which often depend on irri- 
tating articles of diet. 



EMETICS 



53 



4. The glottis is closed, 
so that the various muscles 
compressing the stomach act 
between two fixed points. 

5. As vomiting cannot be 
effectually accomplished if 
the stomach is quite empty, 
under these circumstances 
the patient generally swal- 
lows a certain quantity of air, 
so as to distend the viscus. 



[Where the direct emetics 
are contra-indicated, we may 
resort to the indirect, which 
act by absorption. Emetia 
and apomorphia will cause 
vomiting if injected hypo- 
dermically.] 



1. Action on the Brain 
and Nervous System. — 
Emetics may cause some 
congestion of the brain by 
the obstructed venous return 
from the neck during the 
act of vomiting. 

2. Circulation and Respi- 
ration. — They have a seda- 
tive action on the heart. 

As the respiratory is close 
to the vomiting centre, the 
breathing generally becomes 
sighing and irregular during 
the act of vomiting ; but in 
addition to this there is an 
increase of secretion from 
the pulmonary mucous 
membrane, and the com- 
pression of the lungs forces 
retained mucus out of the 
bronchial tubes. 

3 . Organs of Secretiofi . — 
By the pressure exerted on 
the intestines, some slight 
purgative action may result, 
and prolonged vomiting 
always leads to the discharge 
of bile from the stomach by 
the mechanical squeezing of 
the liver and gall-bladder. 



1. We must therefore 
avoid their use in apoplectic 

cases. 



2. Emetics are of great 
service in clearing the lungs 
in bronchitis, and in getting 
rid of the false membrane 
in croup and diphtheria, 
and they may thus be said 
to act as expectorants. We 
had here best use such 
emetics as ipecacuanha and 
tartarised antimony, which 
combine an expectorant 
action. 



3. Emetics may therefore 
be said to act as cholagogues, 
and may be of great service 
in stimulating the action of 
the liver, and removing 
inspissated secretions from 
the gall-bladder. Some 
authorities hold that it is 
good practice to give an 



54 



EMMENAGOGUES AND ECBOLICS. 



4. Cutaneous. — Emetics 
invariably cause free perspi- 
ration daring their action, 
as well as an increased flow 
of saliva. 



emetic as early as possible 
at the outset of fevers, such 
as enteric ; and it has been 
suggested that the fever 
poison is retained at this 
stage in the bile, and may 
be expelled along with it 
from the system. 



EMMENAGOGUES AND ECBOLICS. 
Of these we may consider, first, 



Ecbolics. 



Physiological Action. 

Ecbolics are substances 
which cause such violent 
contraction of the pregnant 
uterus as to effect the expul- 
sion of its contents. It is not 
quite certain whether the 
principal members of the 
group act specially on the 
muscular structures of the 
organ, or whether a primary 
intervention of nervous in- 
fluence through the spinal 
cord is necessary. 



Therapeutical Action. 

Ecbolics are used exten- 
sively in obstetric practice 
when it becomes necessary 
to stimulate the flagging 
powers of an exhausted ute- 
rus — the principal being 
ergot, digitalis, savin, bo- 
rax, quinine. We are also 
compelled, under certain 
circumstances, to have re- 
course to the induction of 
premature labor, as when 
dangerous sickness goes on 
unchecked, or when weak- 
ened abdominal or thoracic 
viscera are injuriously com- 
pressed by the pregnant 
uterus. In such cases, how- 
ever, it is generally found 
best to use mechanical 
means. 



EMMENAGOGUES 

May be direct or indirect. 



EXPECTORANTS. 



55 



Physiological Action. 

Direct emmenagogues act 
merely by restoring the nor- 
mal functions of the uterus 
when these are suspended. 



Indirect emmenagogues 
act by removing some con- 
stitutional condition which 
interferes with the due per- 
formance of the uterine 
functions. Thus amenor- 
rhcea very frequently de- 
pends on anaemia, or con- 
stipation may require re- 
moval before our more spe- 
cial remedies will act. 



Therapeutical Action. 

Most of the ecbolic drugs 
act as emmenagogues when 
given in small doses to a 
non-pregnant patient, and 
to the list we may add rue 
and castor. Of all these, 
however, ergot is by far the 
most effectual. 

The different preparations 
of iron, in combination with 
aloetic or other purgatives, 
act well, and we may aid 
our chances of success by all 
hygienic means, as well as 
by warm hip-baths, leeches, 
and mustard stupes, at the 
normal menstrual periods. 



EXPECTORANTS. 



These are remedies which 
expulsion of secretion from 
may thus be divided : — 

i . The emetic class, which 
are the most efficient of all, 
removing and softening the 
mucus, causing the trans- 
udation of watery fluids, and 
relaxing the muscular walls 
of the bronchial tubes. 



2. Nauseants may also be 
of service as expectorants. 



3. We then have what are 
called the stimulating ex- 
pectorants, acting either on 
the general vascular system, 



facilitate in various ways the 
the bronchial tubes. They 

1. There can be no doubt 
that, when the lungs are 
choked with secretion, a 
good emetic often acts like 
a charm, as in bronchitis, 
whooping-cough, &c. 

We must here use the in- 
direct emetic agents, as am. 
carb., ipecacuanha, &c. 

2. These are merely the 
indirect emetic drugs given 
in small doses, as antimony, 
ipecacuanha, &c. 

3. These are senega, am. 
carb., &c. ; but it is evident 
that any tonic or stimulating 
remedy may frequently act 



56 



PURGATIVES. 



or specially on the nervous 
and muscular structures of 
the lungs. 



4. Those remedies which 
promote secretion from a 
dry and swollen mucous 
membrane. 



5. Expectoration is often 
rendered difficult by tenacity 
of the mucus, which is 
coughed up, only after much 
straining and effort, and 
great relief follows every 
drug which can thin or li- 
quefy the secretion. 

6. Spasmodic contraction 
of the smaller bronchial 
tubes may interfere with 
free expectoration. 



indirectly as an expectorant, 
by improving the tone of the 
circulation and giving the 
patient strength to cough 
and clear his lungs. The 
stimulating expectorants are 
more especially used in the 
later stages of pulmonary 
disease. 

4. In the earlier stages of 
bronchitis much discomfort 
occurs from the dry hard 
cough and difficulty of 
breathing arising from swell- 
ing of the bronchial mucous 
lining. Great relief is ex- 
perienced when free expec- 
toration is established, and 
this may be promoted by 
inhalation of steam, liq. am- 
monii acet. , lobelia, and the 
class of nauseants generally. 

5. We find that alkalies 
act well here, and, if any 
gouty tendency exists, more 
especially potassic iodide. 



6. Here we may hope to 
obtain relief by the use of 
opium, belladonna, stramo- 
nium, tobacco, &c. 



PURGATIVES. 

Purgatives may be divided, first, into two classes de- 
pending on their origin, and these are : — 

1. The inorganic substances, comprising chiefly the 
mercurials and salines. 

2. Those derived from the vegetable kingdom, and 
which depend for their therapeutical action on the pre- 
sence of resins or oils. 



PURGATIVES. 



57 



Their actual modes of operation, however, are much 
more varied, and they will best be considered by division 
under various headings, according to their physiological 
and therapeutical properties. 



i . Laxatives. — These sub- 
stances act by causing a 
slight increase in the peris- 
taltic movements of the in- 
testines, with softening of 
the faeces, which are then 
expelled in a solid and 
formed condition. 



2. Purgatives produce 
more decided effects both 
in stimulating movement and 
secretion ; but it is difficult 
to separate them entirely 
from either class, No. i or 
No. 3. 



3. Drastic Purgatives. — 
These run by insensible gra- 
dations into the preceding 
class. Their action depends 
on an irritation of the mu- 
cous membrane of the in- 
testines, and not only an 
actual increase of secretion 
from their glands, but the 



1. The principal of these 
are sulphur, castor-oil, mag- 
nesia, &c. ; but in addition 
to actual drugs we may in- 
clude various articles of diet, 
as oatmeal, brown bread, 
whole flour, figs, prunes, 
&c, which act purely me- 
chanically. 

Laxatives are useful when- 
ever we desire a mild and 
unirritating effect, as in sim- 
ple constipation from dys- 
pepsia, pregnancy, conva- 
lescence from acute diseases, 
sedentary habit, and other 
causes. 

Castor-oil acts well in the 
early stages of diarrhoea, by 
sweeping away the irritating 
cause. 

2. Rhubarb, senna, aloes, 
and jalap, are reckoned 
among the chief of these, 
and they are used in various 
dyspeptic conditions, rhu- 
barb being more especially 
stomachic, and aloes em- 
menagogue in their proper- 
ties. 

3. In this class we include 
jalap, scammony,colocynth, 
gamboge, and croton oil, 
and they are principally 
used either in obstinate con- 
stipation, or to produce a 
derivative or species of 
counter-irritant effect in va- 
rious forms of brain disease. 



58 



PURGATIVES. 



withdrawal of watery fluids 
from the blood. An over- 
dose, therefore, may be at- 
tended by serious depres- 
sion, discomfort, and even 
by death from inflammation 
of the bowel. 

4 . Hydragogue purgatives 
cause very free secretion 
from the mucous membrane 
of the bowels, and empty the 
veins by withdrawing fluids 
from the blood. 



5. Saline Purgatives. — 
We have already, when 
treating of sulphate of mag- 
nesia, considered the action 
of this class, and have 
pointed out how, from their 
low diffusive power, they 
pass with difficulty into the 
blood, and how, whilst in 
the intestine, they not only 
absorb, retain, and carry 
away the watery fluids 
which they find in the intes- 
tine, but also directly with- 
draw fresh supplies from the 
blood itself. 

6. Cholagogue Purga- 
tives. — Much experiment 
has recently been expended 
on the action of this class, 
and those recently conduct- 
ed on improved principles 
by Prof. Rutherford have 
given us very precise and 
reliable indications for 
practice. Cholagogues act 
either by directly stimulat- 
ing the secretion of the bile, 



4. These are elaterium, 
cream of tartar, &c, and 
they are most useful in as- 
cites and other dropsical 
conditions, and for the re- 
lief of a feeble and laboring 
heart by diminishing the 
actual volume of the blood. 

5. Sulphate of magnesia 
and many of the salts of 
potash and soda must here 
be included. They are best 
given 111 a state of free dilu- 
tion, and form very efficient 
habitual purgatives, more 
especially in the form of 
various natural purgative 
waters, such as Friedrichs- 
hall, and Pullna. [Hunjadi 
Jan os, Congress Water, 
&c] 



6. The principal members 
of this group are mercury, 
podophyllin, rhubarb, aloes, 
jalap, etc. They are used 
for the relief of various 
functional affections of the 
liver, to remove what is 
commonly known as 
' biliousness,' and to obvi- 
ate portal congestion. 



PURGATIVES 



59 



or by contracting the gall- 
bladder and irritating the 
duodenum, so as to sweep 
the bile out of the intestine 
as fast as it is poured in by 
the hepatic ducts. 

In addition to drugs be- 
longing to the actual purga- 
tive class, we have many 
indirect remedies which act 
with considerable efficiency. 
Thus we may use enemata, 
cold to the abdomen, me- 
chanical kneading of the 
parietes, electricity; we 
may stimulate the muscular 
tissues to contraction ; or 
we may cause a purgative 
action by relieving spasm. 



Among the stimulating 
class we may mention 
strychnia, nux vomica, er- 
got, sulphate of iron, etc., 
and these are very efficient, 
in combination with mild 
purgatives, where constipa- 
tion depends on a lax or 
weakened state of the 
intestinal walls. 

When spasm or irregular 
contraction prevents free 
action of the bowels, we 
must have recourse to opium, 
belladonna, or acetate of 
lead, which, under these 
conditions, may be looked 
upon as true cathartics. 



In administering purgatives, we must consider the vari- 
ous parts of the intestinal canal on which they act.- Thus 
senna, jalap, &c, act on the small intestine, aloes on the 
large, podophyllin on the duodenum, &c. We must also 
consider the time of their administration, as we find that 
the slowly acting resinoid substances are best given at night 
or before dinner, whereas the salines are best taken on an 
empty stomach, and more especially before breakfast. 
The mode of administration is also worthy of note, the 
resinoids being best taken in the form of pill, whereas the 
salines act best in solution with free dilution and in com- 
bination with bitters, iron, or sulphuric acid. 



REMEDIES 



COMPRISED IN THE 



PRIMARY LIST OF THE UNITED STATES 
PHARMACOPCEIA. 



ABSINTHIUM— WORMWOOD. 

[ The tops and leaves of Artemisia Absinthium, U. S.~\ 

Wormwood was formerly used as a bitter tonic and an- 
thelmintic, but it has now quite disappeared from practice. 
Its prolonged use as a beverage, in the form of liquor, has 
been shown to produce a condition of enfeeblement and 
irritability of the nervous system, with a tendency to epi- 
leptiform convulsions. 

[In combination with other herbs, it is sometimes used 
in domestic practice under the name of German Tea. 
Wormwood entered into the composition of the once 
famous "thieves' vinegar," Vinaigre des qualre voleurs 
(IVysten. Diet, de Med.'). The plant contains a volatile 
oil, which gives name and flavor to absinthe, a highly- 
pernicious but popular drink in France.] 



ACACIA— GUM ARABIC. 

\_A gummy exudation from Acacia vera and other species 
of Acacia, U. S. 

Officinal Preparations, U. S. 

Syrupus Acaciae, used as a vehicle. 
Mucilago Acaciae, used as a vehicle. 

Also enters into Mistura Amygdalae, Mistura Cretae, and 
Mistura Glycyrrhizse Composite, 1 and is used as an ex- 
cipient and dusting-powder for pills.] 

1 [Commonly called Brown Mixture.] 
6 (61) 



62 VINEGAR ACETIC ACID. 

Gum is demulcent, and in the form of mucilage is much 
used for the suspension of bulky and insoluble powders, as 
well as to prevent the precipitation of the resin, which en- 
sues when such substances as tincture of myrrh, tinct. 
cannabis Indicse, &c, are added to water. 

[Gum-Arabic water may be given as a demulcent drink 
in fevers^ in angina, in gast?'o- enteric inflammation, and 
dysentery. It has some slight nutritive properties.] 

[ACETUM—VINEGAR. 

Impure dilute acetic acid prepared by fermentation, U. S. 

Officinal Preparations, U. S. 

Acetum Destillatum, used in making Tinctura Opii 
Acetata. 

External and Internal Uses. 

Vinegar, more or less diluted, is a favorite domestic 
application in headache, sprains or bruises, and sun-burn; 
it is also used as a clyster against ascarides. It may be 
given as a refrigerant drink in fevers ; and in these cases 
it is frequently applied to the surface of the body, with a 
sponge, as a means of reducing high temperature. In 
small amounts vinegar aids digestion, but in excess pro- 
duces degeneration of the gastric tubules and thickening 
of the coats of the stomach. It is supposed to act on the 
blood by influencing its crasis, and reducing the propor- 
tion of fibrin. It has been found an efficient remedy in 
scurvy, in combination with nitre (§j. to Oj.), of which an 
ounce may be given four times daily.] 



ACIDUM ACETICUM— ACETIC ACID. 

[Acetic acid of specific gravity 1. 047, U. S. 

Officinal Preparations, U. S. 
Acidum Aceticum Dilutum. (f^ij. in Oj.) Dose 

Also enters into Acetum Lobelice, 1 Acetum Opii, 1 Acetum 
Sanguinarise, 1 Acetum Scillse 1 (Syrupus Scillse), Emplastrum 

1 [These four, with Acetum Destillatum, comprise the class of Vine- 
gars, or Aceta, of the Pharmacopoeia.] 



ACETIC ACID. 63 

Ammoniaci, Extractum Colchici Aceticum, Extractura 
Ergotas Fluidum, Liquor Ammonii Acetatis, Syrupus Allii, 
Potassii Acetas, and Zinci Acetas. 

Antidotes. 

In poisoning by acetic acid, alkalies or their carbonates 
may be given, properly diluted, and vomiting encouraged 
by large draughts of warm water containing soap.] 

External Action. 

Strong, or glacial acetic acid, is a favorite and very suc- 
cessful application to warty groiuths, whether of venereal 
origin or not. The little tumor is touched several times 
with a glass rod, or brush, or a piece of wood dipped in the 
acid, care being taken that none of the fluid trickles down 
over the neighboring structures. A few repetitions of this 
process will generally prove effectual. It is also topically 
used in some obstinate forms of skin disease, and more 
especially the varieties of tinea comprised under the term 
ringworm. The acid probably acts by directly attacking 
and destroying the parasitic growth on which the trouble- 
some affections depend. Acetic acid is also occasionally 
applied to corns. 

Another mode of local use was proposed by Dr. Broad- 
bent some years ago, and strong hopes were then enter- 
tained that a remedy had been at last found for cancer. 
Observing the destructive influence of the acid on cancer 
elements out of the body, Dr. Broadbent very reasonably 
expected that a similar effect might be produced within 
the living organism, and advised the injection of diluted 
acetic acid into the substance of the cancerous mass. 
Some evidence seemed to be adduced in its favor, but its 
action being painful, tedious, and uncertain, the process 
has now fallen into perhaps unmerited oblivion. 

Internal Use. 

Acetic acid is seldom used internally, although it forms 
an agreeable and effectual remedy for the checking of 
night sweats, and Graves used thus to prescribe it. 

The varieties of acetic acid are : Acidum aceticum, from 
which are prepared acidum aceticum dilutum and oxymel, 



64 ARSENIOUS ACID CARBOLIC ACID. 

the doses being of acid. acet. dil. f5j- to f 5 i j - > oxymel 
[Br.] f 5j- to f5ij- '} an d acidum aceticum glaciale. Then 
we have vinegar, the strength of which corresponds pretty 
accurately with the dilute acid, and which is purely a 
domestic remedy for headache, hysteria, and other allied 
conditions. 



ACIDUM ARSENIOSUM— ARSENIOUS ACID. 

\_Siiblimed arsenious acid in masses, U. S. See ARSENIC.~\ 



[ACIDUM CARBOLICUM IMPURUM. 

Impure carbolic acid, U. S. Used only as an external remedy or for 
disinfecting purposes . ] 



ACIDUM CARBOLICUM— CARBOLIC ACID. 

\_A solid sttb stance obtained from the products of the distillation of coal- 
tar, betzoeen the temperatures of 300 and 400 , U. S. 

Dose, gtt. i.-ij., in pill or solution. 

Officinal Preparations, U. S. 

Glyceritum Acidi Carbolici. Dose -n^x.-xl. 
Unguentum Acidi Carbolici (5j. to 3j.). 

Antidotes. 

There are no direct antidotes to poisoning by carbolic 
acid. Alkalies, soap, or the fixed oils may be given, with 
demulcent drinks, and the stomach evacuated with a pump 
or syphon, as the local effect of the acid will generally 
prevent emetics from acting.] 

Local Action. 

Physiological Effects. Therapeutical. 

Carbolic acid is, in the It is therefore much used 
first place, an antiseptic, as an antiseptic and deodor- 
from its power of destroying ant for the treatment of 111- 
the minuter forms of animal smelling drains, etc., or to 
and vegetable life. destroy the infectious pro- 

perties of various secretions 
or discharges from the sick. 
It may also be useful as a 
lotion or injection to foul 
sores. 



CARBOLIC ACID. 



65 



Carbolic acid is an irri- 
tating substance, and, if 
applied sufficiently long to 
the skin, will cause slough- 
ing. 

It has, however, un- 
doubted anaesthetic proper- 
ties. 



It is also readily absorbed 
through the skin. 



Although carbolic acid 
may be of use in correcting 
fcetor, it is too irritating to 
make a good lotion for 
wounds or ulcers, [unless 
properly diluted, with oil (1 
in 24) or water (3j. to Oj.), 
when it forms an admirable 
dressing.] It has been used 
as a caustic in some ulcera- 
tive affections, as lupus. It 
has been recommended as 
a local anaesthetic during 
small operations, and to 
deaden the pain of some 
caustic applications. [The 
pain of opening a. felon may 
be greatly reduced by pre- 
viously immersing the finger 
for a few minutes in a 3 to 
5 per cent, solution of car- 
bolic acid.] 

We must therefore re- 
member that symptoms of 
poisoning may readily be 
produced by the application 
of carbolic acid over any 
considerable cutaneous area. 



Antiseptic System of Prof. Lister. 



6* 



Its principal application, 
however, in surgery, is in 
enabling us to carry out the 
far-famed antiseptic system 
of Prof. Lister. 

This eminent surgeon, 
adopting the views of Pas- 
teur, and believing that sup- 
puration, pyaemia, and vari- 
ous other inconveniences 
connected with open 
wounds, arise from the 



66 CARBOLIC ACID, 



irritation of minute germs 
contained in the air, has 
devised a process in which 
the atmospheric air, before 
reaching the raw surface, is 
filtered through carbolic 
acid and thus deprived of 
its irritating properties. 

The acid itself, being 
extremely irritating, is pre- 
vented from coming in con- 
tact with the wound or sore 
by a protection of oiled 
silk, over which are super- 
posed several layers of 
gauze impregnated with 
paraffin i6 parts, resin 4 
parts, and carbolic acid 1 
part ; and this dressing 
need not necessarily be 
changed oftener than every 
two or three days. 

Mr. Lister prevents the 
access of air during opera- 
tions by surrounding the 
part with an antiseptic 
atmosphere, composed of a 
sprayed watery solution of 
carbolic acid of 1 to 40, 
and the instruments and 
fingers of the surgeon are 
carefully washed with car- 
bolized oil, whilst the arte- 
ries are tied with carbolized 
cat-gut ligatures, cut off 
short. By adopting these 
precautions, and attending 
most rigorously to the care- 
ful dressing of wounds, he 
has obtained excellent re- 
sults, not only after ordi- 
nary operations, but in 
chronic abscesses wherever 



CHROMIC ACID. 



6 7 



situated, compound frac- 
tures, and various diseased 
conditions connected with 
joints, whose cavities he is 
enabled to open and explore 
with perfect safety. 



Internal Action. 



Carbolic acid, if adminis- 
tered in sufficient quantity, 
is very poisonous in its ope- 
ration, causing failure of the 
heart's action, spinal con- 
vulsions, gastro-intestinal 
irritation, and lowered tem- 
perature. Its antiseptic 
properties sufficiently ex- 
plain its internal use. 



Carbolic acid has occa- 
sionally caused death by 
being accidentally drunk in 
mistake for beer, or by being 
incautiously applied to the 
skin. The best antidotes 
are olive oil and saccharated 
lime. 

It is occasionally given 
internally to counteract 
flatulence and s arduous 
vomiting; but the sulpho- 
carbolates, and more espe- 
cially that of soda, are the 
most convenient forms for 
its administration in doses 
of 15 to 30 grains. [Car- 
bolic acid has been recom- 
mended for tenia, in pill- 
form, taking three to five 
grains in the course of the 
day.] 

Absorption and Mode of Elimination. 

Carbolic acid is rapidly absorbed, and quickly and 
entirely given off by the urine, to which it imparts a pecu- 
liar greenish-black hue and its own peculiar smell. 



[ACIDUM CHROMICUM— CHROMIC ACID. 

No Officinal Preparations, U. S. 

Effects and Uses. 

Chromic acid is an escharotic and antiseptic ; it rapidly 
oxidizes organic matter and is the most energetic disinfectant 



68 CITRIC ACID . 

known. A strong solution (gr. c. to f*j.) may be applied 
with a glass rod, to destroy warts, condylomata, and excres- 
cences, or to reduce enlarged tonsils. Greatly diluted (gr. ss. 
to f^j.) it forms a detergent wash for mercurial stomatitis, 
scurvy, diphtheria, oedema of the glottis, ulcers, and phage- 
dena. On account of the difficulty of limiting its effect 
it should not be applied in substance, as when used in 
this manner to destroy warts on the fingers it has been 
known to eat into the joint and require amputation of a 
phalanx.] 



[ACIDUM CITRICUM— CITRIC ACID. 

Officinal Preparations, U. S. 

Liquor Ferri Citratis, Liquor Magnesias Citratis, Liquor 
Potassii Citratis, Lithii Citras, Potassii Citras, Syrupus 
Acidi Citrici, and in preparing Ferri Pyrophosphas. 

Dose. gr. xx.-xxx. 

Effects and Uses. 

As a refrigerant in fevers, citric acid solution is used in 
the form of lemonade, neutral mixture (mistura potassii 
citratis), or the citrates. It has been used in scurvy, liver 
disease, and rheumatism, and as an application to the 
throat in diphtheria (gr. viiss. to f,lj.). Dr. H. Bence Jones 
believes that lemon juice and citric acid increase the 
acidity of the urine ; they consequently are contra-indi- 
cated in lithuria, and should not be given for a length of 
time, continuously, in the gouty diathesis.] 

External Use. 

Citric acid was proposed a few years ago as a soothing 
local application to cancerous sores. 

Internal Use. 

Citric acid is used chiefly as a cheap and convenient 
substitute for lemon juice in effervescing draughts, which 
are very extensively prescribed on account of their cool- 
ing and refreshing properties in feverish conditions, and 
for the soothing influence of their carbonic acid when the 
stomach is irritable. 

Whenever lemon juice can be procured, it should be 
used in preference; but at periods of the year when this 



DILUTE HYDROCYANIC ACID 



6 9 



fruit is out of season, citric acid will act well, and we here 
give a table from Squire, showing the proportions in which 
the acid and alkali should be prescribed to insure exact 
saturation. 

' 25 grs. bicarbonate of potash. 

20 " carbonate of potash. 

20 

35 
15 
13 

Acidumtartaricum, being cheaper than citric acid, is often 
used to construct effervescing draughts. 



17 grs. of cit- 
ric acid, or 
half a fluid ( 
ounce of 

fresh lemon 
juice 



will 
neutralize 



bicarbonate of soda, 
carbonate of soda. 
carbonate of ammonia, 
carbonate of magnesia. 



ACIDUM HYDROCYANICUM DILUTUM— 
DILUTE HYDROCYANIC ACID. 

\_A tzvo per cent, sohition of Hydrocyanic acid in water. 

Antidotes. 

Chlorine or ammonia may be cautiously administered, 
accompanied by cold affusions to the spine, and artificial 
respiration. As a chemical antidote, sulphate of iron (gr. 
x.), and tincture of the chloride of iron (f5j-)> dissolved in 
a fluid ounce of water, may be given immediately, to be fol- 
lowed by twenty grains of carbonate of potassium, like- 
wise in solution, forming with the poison insoluble Prus- 
sian blue.~\ 

External Action. 



Physiological. 

Prussic acid, applied to 
the skin in a concentrated 
form, may cause at first 
slight irritation, but second- 
arily diminishes its sensibi- 
lity, acting in some degree 
as an anaesthetic, probably 
from a benumbing influence 
on the extremities of the 
sensory nerves. 



Therapeutical. 
It is therefore used exter- 
nally, largely diluted, to re- 
lieve neuralgic pain and 
allay itching, more espe- 
cially in skin disease. We 
may thus hope to alleviate 
the tormenting irritation 
often attending prurigo and 
eczema; but we must be 
careful never to let the lo- 
tion come in contact with 
any abrasion on the surface, 
as prussic acid is very rea- 
dily and rapidly absorbed. 



7° 



DILUTE HYDROCYANIC ACID. 



H; 



Internal Action. 



'ydrocyanic acid, being the most powerful and speedy 
poison with which we are acquainted, requires to be pre- 
scribed with very great caution. 



Physiological. 

i . On the Nervous System . 
— Prussic acid has some ef- 
fect on the brain, causing 
giddiness and slight stupor; 
the respiratory centre in the 
medulla next becomes weak- 
ened, and the motor nerves 
are more or less paralyzed, 
causing excessive muscular 
feebleness. 



2. The respiration be- 
comes slow and irregular, 
and finally ceases, death in 
cases of poisoning being 
generally due to suffocation. 
The sensory nerves are also 
enfeebled in their conduct- 
ing power. 

3. Prussic acid has a pow- 
erful sedative action on the 
heart, the circulation be- 
coming slow, feeble, and ir- 
regular under the influence 
of poisonous doses ; and this 
arises both from an influence 
on the nerves and on the 



Therapeutical. 

1. It is used with great 
benefit in those forms of dys- 
pepsia attended with epigas- 
tric pain and vomiting fol- 
lowing food, and whether 
depending on gastric ulcer 
or on mere irritation of the 
mucous membrane. It has 
also been given in whooping- 
cough; but in my experience 
its action is here very uncer- 
tain, and I have been unable 
to satisfy myself that it is a 
remedy of much value. In 
some forms of chronic and 
spasmodic cough it does 
good, but it is essentially in 
dyspepsia that we obtain real 
advantage from its use. 



3. It has been successfully 
employed in nervous palpi- 
tation [or irritable heart]. 



DILUTE HYDROCYANIC ACID. 



71 



muscular structures of the 
heart itself. 

It also acts directly on the 
blood, combining with the 
haemoglobin of the red cor- 
puscles, and preventing them 
from properly fulfilling their 
duty of carrying oxygen to 
the tissues. 

4. Prussic acid has no 
special influence on the tem- 
perature or on secretion, save 
that the saliva is generally 
increased in quantity. 

Prussic acid is very rapidly eliminated from the system, 
probably by the breath, and half an hour may be sufficient 
for this purpose, so that in a case of poisoning we may 
have good hopes of recovery, if we can sustain the powers 
of life during this period. 



Poisonous Effects. — In a 
large dose prussic acid kills 
immediately, the victim fre- 
quently uttering a loud cry, 
and expiring from cardiac 
syncope. If the quantity 
taken be smaller, symptoms 
of suffocation supervene 
from paralysis of the respi- 
ratory centre, and, if the 
process of poisoning be more 
gradual, from deficient" sup- 
ply of oxygen in the blood ; 
other symptoms noted being 
convulsions, great muscular 
prostration, dilatation of pu- 
pils, and quick, feeble, irre- 
gular pulse. In fatal cases, 
post-morteni examination 
shows nothing characteris- 
tic. 

If the poison be taken in 



Antidotes. — Considering 
the great rapidity of the ac- 
tion of hydrocyanic acid, it 
is comparatively seldom that 
we have any opportunity of 
employing antidotes ; but 
supposing we see a case suf- 
ficiently early to do so, we 
should have vigorous re- 
course to cold affusion and 
the inhalation of ammonia 
and chlorine water. Artifi- 
cial respiration should be 
then steadily persisted in, 
and if we can thus counter- 
act the tendency to death 
by suffocation, and tide the 
patient over the first half- 
hour, we may look forward 
to success, never despairing 
as long as the faintest pulsa- 
tion can be felt in the heart. 



72 



DILUTE HYDROCYANIC ACID. 



a concentrated form, death 
may ensue very rapidly, in 
less probably than a minute ; 
and Preyer, who has devo- 
ted special attention to the 
subject, has observed a gui- 
nea-pig to be apparently 
dead one second after inhal- 
ing some gaseous acid, all 
efforts at breathing having 
finally ceased in fifteen sec- 
onds. He, therefore, consid- 
ers this to be the most deadly 
mode of its administration ; 
but no matter through which 
channel it enters the body, 
it speedily kills any animal, 
and, curiously enough, it 
is equally destructive to 
plants. 



Secondary auxiliary means 
exist in the internal adminis- 
tration of ammonia, of chlo- 
rine water, or of carbonate 
of potash, followed by the 
mixed sulphates of iron, 
which convert the poison 
into prussian blue ; and re- 
cently the subcutaneous in- 
jection of atropia has been 
proposed as the true physio- 
logical antidote. 



Dose and Mode of Administration. 

One grain of anhydrous acid has caused death, and of 
this the preparation used in medicine contains 2 per cent., 
the old Scheele's, which is now obsolete, having contained 
4 per cent. 

In consideration of the rapid way in which the acid is 
thrown out of the system, we must repeat the dose fre- 
quently, from every hour to every three hours ; and it is 
well not to order too large a quantity at one time, not be- 
cause the acid tends to float on the top, as was formerly 
supposed, but because there is always a chance of an over- 
dose being given through ignorance or carelessness. We 
may safely prescribe from 2 to 6 minims [beginning always 
with gtt. j.], suspending it if the patient complains of any 
constriction about the throat. For external use f3ij. niay 
be dissolved in 8 ounces of water or rose water. 

$.. Acidi hydrocyanici diluti f5\j- ; 

Glycerini f^j. ; 

Aquae rosse ad f^viij. 

Misce, fiat lotio. 

In a case of troublesome itching. 



LACTIC ACID — NITRIC ACID. 73 

R. Acidi hydrocyanici diluti TT^xij. ; 

Misturae amygdalae ^I v j« 

Misce, fiat mistura. Capiat cochlearia duo magna tussi 
admodum ingravescente. 

For a case of irritable cough. 

R. Acidi hydrocyanici dil. tt\_xxv. ; 

Bismuthi subnitratis £ss. ; 

Syrupi aurantii f § j . ; 

Gentianae infusi ad f gviij . 

Capiat cochlearia magna ter in die ante cibum. 

In a case of irritative dyspepsia. 

Or, a few drops of prussic acid may be added to the 
ordinary effervescing draught with good effect. 



[ACIDUM LACTICUM— LACTIC ACID. 

Officinal Preparation, U. S. 
Ferri Lactas. Dose gr. v. 

A syrupy, nearly transparent liquid, with slight odor 
and a very sour taste, obtained from sour milk. It exists 
normally in the gastric juice, and hence is a useful addi- 
tion to preparations of pepsin. It has been given in 
dyspepsia (f3j- s. t. d.) in sweetened water at meal-time. 
Locally it has been employed (diluted four-fifths) as an 
application to the false membrane in croup and diphtheria. 

According to Prout, rheumatism is connected with an 
excess of lactic acid in the blood ; and this fact accounts 
for the benefit derived from the alkaline treatment.] 

ACIDUM NITRICUM— NITRIC ACID. 

\_Nitric acid of the specific gravity 1.420, U. S. 

Officinal Preparations, U. S. 

Acidum Nitricum Dilutum (f^iij. to Oj.). Dose, 
nrv.-xxx. 

Also enters into Acidum Nitro-muriaticum, Argenti 
Nitras, Bismuthi Subnitras, Liquor Ferri Nitratis, Liquor 
Hydrargyri Nitratis, Spiritus ^Etheris Nitrosi, Unguentum 
Hydrargyri Nitratis, and in the preparation of Acidum 
Phosphoricum Dilutum, Antimonii Oxidum, Bismuthi 
Subcarbonas, Cadmii Sulphas, Hydrargyri Oxidum Ru 
7 



74 NITRIC ACID . 

brum, Liquor Ferri Chloridi, Liquor Ferri Subsulphatis, 
Liquor Ferri Tersulphatis, Liquor Zinci Chloridi, and 
Pyroxylon. 

Antidotes. 

The same treatment as indicated for poisoning by Muri- 
atic Acid and the other mineral acids. Nitric acid stains 
the skin yellow. ] 

External Use. 

Nitric acid is undoubtedly the best form of local applica- 
tion in all forms of sloughing or phagedenic ulceration, 
whether of venereal origin or otherwise. In these rapidly 
destructive forms of disease, we shall do well to place our 
patient under the influence of an anaesthetic, and then apply 
the strong acid freely and thoroughly to all parts of the affect- 
ed surface, and we shall thus often succeed in arresting a 
process which would otherwise go on to severe and even 
fatal disorganisation. 

It is also used locally in the treatment of piles, more 
especially those flat irritable forms of tumour which do 
not come readily within the reach of the clamp or ligature. 

In the proportion of 10 or 20 minims to an ounce, nitric 
acid forms a good astringent lotion in cases of indolent or 
unhealthy sores; and it has been recommended by Dr. 
Roberts, of Manchester, as an injection into the bladder 
for the solution of phosphatic calculi. 

Internal Use. 

Given internally, nitric acid has tonic properties, and, 
in combination with bark and opium, acts well in cases of 
foul or sloughing ulceration. Again, in constitutions 
broken down by syphilis or by chronic hepatic disease, 
we may very beneficially give our patient from 15 to 20 
minims of the dilute acid three times a day, its action on 
the liver being by some supposed to have somewhat of a 
specific character. 

J&. Acidi nitrici diluti f^U- 5 

Tincturee opii ttL x h ; 

Tincturas cinchonas f §ss. ; 

Decocti cinchonas ad f§viij. 
Misce, capiat f§j. ter in die. 

In a case of foul or sloughing ulcer. 



OXALIC ACID — TARTARIC ACID. 75 

ACIDUM NITRO-HYDROCHLORICUM.— 
[NITRO-MURIATICUM, 3 to 5. 
Dose, 5 to to minims, well diluted. 

Acidum Nitro-Muriaticum Dilutum (f^iv. to Oj.). 
Dose r^x.-xv.] 

This is supposed to have some special action on the 
liver, and is most extensively used in chronic functional 
affections of that organ. It has also been highly recom- 
mended, in the form of bath, in various hepatic disorders 
in the proportion of 6 fluid ounces to each gallon of water. 

I£. Acidi nitro-muriatici diluti f^ii- ; 

Succi [extract] taraxaci f §>s. ; 

Spiritus chloroformi [Br.] f3) ss - > 

Aquae ad fgviij. 
M. Capiat f^i. ter in die. 
In a case of sluggish liver. 



[ACIDUM OXALICUM— OXALIC ACID. 

Officinal Preparation, U. S. 
Ferri Oxalis. Dose, gr.ij.-iij. 

Antidotes. 

Magnesia and lime form insoluble precipitates with 
oxalic acid, therefore compounds containing chalk or mag- 
nesia would constitute chemical antidotes. Tooth-powder, 
lime-water, oxide and carbonate of magnesia, or "the 
scrapings of the ceiling with a fire-shovel," may be given 
with propriety in cases of poisoning; which are not infre- 
quent, since, owing to the resemblance between oxalic 
acid and Epsom salts, one may be accidentally substituted 
for the other. 

Effects and Uses. 

Oxalic acid has been used, in small doses, internally, 
in scurvy and phthisis, but has nothing particular to com- 
mend it.] 



[ACIDUM TARTARICUM— TARTARIC ACID. 

Officinal Preparations, U. S. 
Ferri et Ammonii Tartras. Dose gr.x-xxx. 
Pulveres Effervescentes. (Soda powders.) 
Pulveres Effervescentes Aperientes. (Seidlitz pow- 
ders.) 



76 ACONITE. 

Antidotes. 

The alkalies, magnesia, lime, soap, or the alkaline car- 
bonates. 

Internal Use. 

It has been stated that tartaric acid, in 10-20 grain 
doses, given thrice daily will render the urine acid. The 
tartrate of magnesium has been recommended as a cheaper 
substitute for the citrate, as an aperient, and is considered 
quite as efficient. In sweetened solution, tartaric acid is 
sometimes used as a refrigerant drink in fevers. The tar- 
trates are laxative and diuretic] 

[List of Acida, or acids, officinal in the U. S. Pharma- 
copoeia : — 

Acidum Aceticum Acidum Nitricum Dilutum 

" " Dilutum " Nitro-Muriaticum 

" Arseniosum " " Dilutum 

" Benzoicum " Oxalicum 

" Carbolicum " Phosphoricum Dilutum 

" " Impurum " " Glaciale 

" Chromicum " Sulphuricum 

" Citricum " " Aromaticum 

" Gallicum " " Dilutum 

" Hydrocyanicum Dilutum " Sulphurosum 

" Lacticum " Tannicum 

" Muriaticum " Tartaricum 

" " Dilutum " Valerianicum.] 

" Nitricum 



ACONITUM— ACONITE. 

[Aconiti Folia. — The leaves of Aconitum Napellus, 
U. S. 

Aconiti Radix. — The root of Aconitum Napellus, U. S. 

Officinal Preparations, U. S. 

Aconitia (from the root). Not given internally. 
Extractum Aconiti (of the leaves). Dose gr. ss. 
Emplastrum Aconiti (from the root). 
Linimentum Aconiti (from the root). 
Tinctura Aconiti Radicis. (gvj. to Oj.) gtt. j.-v. 

{Fleming's tincture of aconite root contains §xss. to Oj.) 



ACONITE. 



77 



Antidotes. 

Finely powdered animal charcoal, tannin, astringent 
infusions, and hot alcoholic stimulants, are useful. The 
stomach should be carefully washed out, and subsequent 
symptoms met pro re nata.~\ 



Poisonous Properties. 

Aconite may kill either by 
direct cardiac syncope, or, 
if the action is less rapid, by 
respiratory failure. Great 
muscular weakness is noted, 
the heart's action becoming 
feeble and irregular, the 
face pale, the body bedewed 
with clammy sweat, the pu- 
pils first contracted and then 
dilated, shortly before death 
closes the scene. The re- 
semblance of aconite root 
to horse-radish has afforded 
several opportunities of 
studying lamentable cases 
of accidental poisoning. 



Therapeutical. 

In poisoning by aconite, 
we must endeavor to sustain 
the flagging action of the 
heart by giving stimulants, 
and keeping the patient 
most rigidly in the re- 
cumbent posture, as death 
has occurred from syncope 
produced by suddenly sit- 
ting up in bed. Digitalis 
has been proposed as the 
physiological antidote, 

bracing up and restoring 
the contractility of the 
heart muscle (Fothergill). 
[20 minims of tincture of 
digitalis may be adminis- 
tered hypodermically.] 



Local Action. 



Physiological. 

Aconite, locally applied, 
causes a sensation of tingling, 
followed by numbness of 
the skin, from a paralysing 
influence, no doubt, on the 
sensory nerves. It may also 
bring about some local vaso- 
motor paralysis. 



Therapeutical. 

Aconite is a most valuable 
local sedative in painful 
nervous affections, and more 
especially in facial neural- 
gia , where the tincture or 
liniment, applied along the 
course of the affected nerve, 
will often allay and even 
remove suffering. 



Constitutional Action. 

Physiological. Therapeutical. 

I. On Nervous System. — 
1. Brain. — In poisoning by 



78 



ACONITE. 



aconite, the intellectual 
faculties are usually quite 
unaffected, but in some cases 
stupor has been observed. 

2. Spinal Cord. — Aconite 
paralyses both the reflex and 
the motor activity of the 
cord, as evidenced by almost 
total loss of power in the 
muscular system. 

The respiratory centre 
also eventually becomes 
paralysed, and death may 
result by suffocation. 

3. Although this loss of 
voluntary movement is sup- 
posed to be primarily spinal 
in origin, it is believed that 
the motor nerves themselves 
are secondarily affected, the 
paralysing influence begin- 
ning at their peripheral 
extremities. The inhibitory 
cardiac ganglia are first 
stimulated, and secondly 
depressed, and a sedative 
effect is produced on the 
sensory nerves, the earliest 
indication of the action of 
the drug being tingling fol- 
lowed by numbness and 
anaesthesia of the lips and 
throat. 

Opinions differ as to the 
influence of aconite on the 
vaso-motor nerves, and it is 
not believed by many 
authorities to have any 
special operation over this 
system. Dr. Bagshawe, 
however, has published some 
cases of facial sympathetic 
paralysis, with injection and 



3. Aconite is one of our 
best remedies in facial neu- 
ralgia, given either alone or 
in combination with quinine. 
In sick headache also it is of 
service, and here it will be 
prescribed along with tinc- 
ture of Indian hemp. 



ACONITE. 



79 



sweating, following the 
local application of aconite, 
and the diaphoretic action, 
so often noted, must proceed 
from this cause. Experi- 
mental evidence, however, 
is very conflicting in this, as 
well as in other points, 
respecting the physiological 
actions of aconite. 

II. Circulating Apparatus . 
Aconite is essentially a car- 
diac sedative, slowing the 
action of the heart at first 
from inhibitory stimulation, 
but then causing an increase 
in the rapidity of the pulsa- 
tions, with feebleness and 
irregularity, ending in death 
by arrest of all movement 
in diastole. At the same 
time the arterial pressure 
falls in very marked degree. 



III. Respiration and Tem- 
perature. — The respiratory 

movements tend to become 
slow, finally irregular, and 
in some cases, and almost 
universally in the lower 
animals, death results from 
cessation of breathing. 

The temperature falls 
decidedly. 

IV. Digestive and Secret- 
ing Apparatus. — Aconite 
has no special influence on 
digestion. It increases 
somewhat the salivary secre- 
tion, and augments largely 



II. Aconite is an excellent 
antiphlogistic, cutting short 
inflammatory processes in 
their early stages. Thus in 
pneumonia, pleurisy, perito- 
nitis, erysipelas, rheumatic 
fever, and in the short sharp 

feverish affections of child- 
ren, it is of signal service, 
and seems to have a directly 
curative action. In coryza 
and in acute tonsillitis, also, 
it has been much praised 
for the way in which it 
checks the full development 
of these troublesome affec- 
tions. 

III. Some part of the 
good effect of aconite in 
these febrile affections must 
be due to its power in slow- 
ing the breathing and re- 
ducing the temperature. 



80 LARD. 

the action of the perspira- 
tory apparatus of the skin, Aconite is therefore an 
bringing out in some in- excellent diaphoretic, 
stances an irritable vesicular 
eruption. The urine is also 
somewhat increased in 
quantity. 

Absorption and Mode of Elimination. 

Aconite is rapidly absorbed, and given out probably 
by the urine. 

Cautions and Modes of Administration. 

The very poisonous nature of aconite renders caution 
necessary in its use, and we must prescribe it with great 
care in old persons, or where any suspicion exists of feeble- 
ness of the heart's action. In sound constitutions, how- 
ever, and more especially in the case of children, we may 
use it with freedom, often obtaining really extraordinary 
results. 

It is essential to encounter the inflammation at an early 
stage, before structural changes have set in; and it is im- 
portant to combine a little stimulant with the drug. In 
very acute cases, our best practice will be to give the tinc- 
ture in small and very often repeated doses, carefully 
watching the effect on the pulse. One drop every ten 
minutes, half-hour, or hour, will be the best arrangement 
during the first day, after which every two hours will be 
a sufficient interval, the thermometer giving us meanwhile 
reliable information regarding the progress of the inflam- 
matory condition. In facial neuralgia, also, we shall ob- 
tain the best results by drop doses repeated at very short 
intervals, and in no case is it well to overstep a maximum 
dose of 5 minims. 

The alkaloid aconitia is occasionally used as a external 
application [in ointment, containing gr. i.-ij. to the ounce]. 



[ADEPS— LARD. 

The prepared fat of Sus Scrofa, U. S. 

Lard is emollient and is sometimes used in frictions, 
but is chiefly employed in Pharmacy in the preparation of 
ointments and cerates. In obstetrical or gynaecological 



ETHER. 8l 

practice, lard is considered to be a universal lubricant, and 
is rarely absent from the lying-in chamber, where it is also 
used as a detergent to remove the vernix caseosa from the 
new-born. Washed lard is occasionally employed to pre- 
vent the eyelids from adhering in catarrhal conjunctivitis. 

List of Unguenta or ointments officinal in the U. S. 
Pharmacopoeia : — 

Unguentum (Unguentum Adipis, Unguentum Hydrargyri Oxidi Flavi 

U.S.P. Ed. i860.) " " " Rubri 

" Acidi Carbolici " Iodinii 

" Acidi Tannici " " Compositum 

" Antimonii " Mezerei 

" Aquae Rosae " Picis Liquids 

" Belladonnae " Plumbi Carbonatis 

" Benzoini " " Iodidi 

" Cantharidis " Potassii Iodidi 

" Creasoti " Stramonii 

" Gallae " Sulphuris 

" Hydrargyri " " Iodidi 

" " Ammoniati " Tabaci 

" " Iodidi Rubri " Veratrise 

" " Nitratis " Zinci Oxidi.] 



/ETHER— ETHER. 1 

[Used in preparing Acidum Tannicum, Ceratum Sabi- 
nae, Oleoresina Capsici, Oleoresina Cubebse, Oleoresina 
Filicis, Oleoresina Lupulinse, Oleoresina Piperis, and 
Tinctura Opii Deodorata. 

Officinal Preparations, U. S. 

^Lther Fortior — pure ether (for producing anaesthesia). 
Spiritus /Etheris Compositus(HorTmann's Anodyne). 
tt^x.-xxx. 

Ether fortior is used in preparing Aconitia, Atropiae 
Sulphas, Collodium, Collodium cum Cantharide, Oleum 
yEthereum, and Oleoresina Zingiberis.] 

Local Action. 

Physiological. Th erapeutica l. 

The projection on the skin Advantage has been taken 

of a very fine spray of spe- of the insensibility to pain 

1 [The class of ./Etherea, U. S. P., comprises /Ether, iEther Fortior, 
Chloroformum Purificatum, and Oleum ^Ethereum. ] 



82 



ETHER. 



cially pure ether, by means 
of Dr. Richardson's ingeni- 
ous instrument, causes at first 
a sensation of extreme cold, 
attended occasionally by the 
formation of ice. In about 
a minute, or even less, to this 
succeeds asudden blanching 
of the surface, the skin be- 
coming hard and quite in- 
sensible, and a sharp cutting 
pain, like a burn, being at 
the same time experienced. 

If this action is kept up 
for some time, redness, 
tingling, vesication, and 
even sloughing may be pro- 
duced. 

Be careful always to pro- 
cure the pure anaesthe- 
tic ether, which has a high 
boiling point, and evapor- 
ates rapidly, as ordinary 
qualities of the drug are 
of no use for local anaes- 
thesia. 



produced by the ether spray, 
to use it extensively during 
the performance of many 
minor operations, and more 
especially in those which 
consist merely of a single 
cut or prick. Under these 
conditions it acts admirably, 
but the hard and brawny 
state of the integument pro- 
duced by its action renders 
it of little or no aid where 
dissection or manipulations 
of deep-seated structures are 
required. Further objec- 
tions to its use are the acute 
pain attending application, 
and the subsequent redness, 
tingling, and irritation of 
the skin. 

It has also been recom- 
mended as a sedative in 
neuralgia, and as a con- 
venient means of applying 
intense cold ; and cases of 
its successful employment 
in chorea, applied to the 
upper part of the spine, 
have been recorded. 



Internal Actions. 

Ether, when taken inter- It is therefore a useful 
nally, is stimulant and anti- remedy in hysteria, flatu- 
spasmodic. lence, spasmodic asthma, etc. 



Combined Internal 
Physiological. 

Ether has powerful anaes- 
thetic properties, and differs 
from chloroform in the fol- 
lowing respects. It increases 
instead of diminishing the 



and External Use. 
Therapeutical. 

The stimulant action of 
ether on the heart has 
caused its use to be warmly 
advocated as in all respects 
superior to chloroform. It 



ETHER. 83 

arterial pressure, and acts as cannot, however, be con- 
a tonic to the heart, which sidered absolutely safe, and 
continues to pulsate in fatal it labors under several dis- 
eases after the arrest of advantages, such as the 
breathing. The following greater length of time re- 
is the order of involvement quired to produce anses- 
of the nerve centres : — thesia, the violent struggling 

1. The cerebrum. occasionally observed, the 

2. The sensory centres of disagreeable smell of the 
the cord. drug, &c. ; and it is there- 

3. The motor centres of fore doubtful whether it will 
the cord. ever effectually displace the 

4. The sensory centres of more commonly-used anaes- 
the medulla oblongata. thetic [*]. 

5. The motor centres of 
the medulla. 

Mode of Administration. 

It is most important that no air be admitted during ether 
administration, as most violent resistance and dangerous 
struggling supervene if the vapor be not inhaled in a state 
of purity. Non-attendance to this point caused ether to 
fall into discredit soon after its original introduction, and 
it is only lately that we have been fully convinced that, by 
using this simple precaution, we may readily obtain com- 
plete anaesthesia and perfect muscular relaxation in from 
three to eight minutes. Various inhalers have been de- 
vised to fit tightly over the mouth and nose, and it is here 
essential that some instrument of the kind should be used. 

When operating by artificial light, do not forget the in- 
flammable nature of the vapor of ether. 

1 [These strictures must be considered as the criticism of an English 
author upon English ether, which is declared to be of very inferior 
quality, by those who have had an opportunity of personally compar- 
ing it with the American. This explains the adherence of the English 
to chloroform, in spite of its acknowledged greater danger; and at the 
same time prevents them from understanding the popularity of ether 
in the United States. The fact is that the washed ether (aether fortior, 
U. S. P.) as made by Dr. Squibb, Powers & Weightman, and others, 
is perfectly free from the objections just stated; it is pure, nearly 
odorless, and efficient in almost the same doses as chloroform, while 
it is incomparably safer than its rival. ] 



84 ALCOHOL. 

ALCOHOI ALCOHOL. 

{Spirit of the specific gravity 0.835, &• ■$• 

Officinal Preparations, U. S. 

Alcohol Dilutum. Diluted one-half with water. 

Alcohol Fortius. Spirit of the specific gravity 0.817. 

Spiritus /Etheris Nitrosi. Dose f5ss.-ij. 

Vinum Xericum. Sherry wine (about 19 per cent, 
alcohol). 

Vinum Portense. Port wine (about 23 per cent, 
alcohol). 

Spiritus Vini Gallici. Brandy (about 50 per cent, 
alcohol). 

Spiritus Frumenti. Whiskey (about 50 per cent, 
alcohol). 

Spiritus Myrcise. Bay rum (for external use). 

(Spiritus Geneva, gin, is not officinal; the Spiritus 
Juniperi Compositus of the Pharmacopoeia may be re- 
garded as its equivalent.)] 

Antidotes. 

The treatment of acute alcoholic poisoning must consist 
in removing all the spirit from the stomach by means of 
the stomach-pump, and endeavoring to rouse the patient 
from his perilous state of coma by cold affusion, strong 
coffee, surface stimulation, and galvanism, whilst artificial 
respiration may be employed to stimulate the flagging 
breathing powers. In more chronic cases, withdraw all 
stimulant absolutely and at once ; insure sleep by chloral 
and bromide of potassium ; and try to diminish the morbid 
craving by capsicum, nux vomica, the mineral acids, and 
a liberal and varied diet. 

Local Actions. 

Physiological. Th erapeutical. 

Alcohol has some exter- This hardening process 

nal astringent properties has been turned to practical 

from its power of hardening account for the prevention 

albumen and thus condens- of bedsores, and alcohol is 

ing the tissues, whilst, from also a usual ingredient in the 

its rapid evaporation, it now somewhat old fashioned 

produces a cooling effect. spirit or evaporating lotions. 



ALCOHOL. 



85 



Internal Actions and Uses. 



1 . On Brain and Nervous 
System. — Alcohol primarily 
stimulates the cerebral cen- 
tres by dilating their arte- 
ries, and so admitting more 
blood ; secondly, excite- 
ment supervenes with im- 
paired muscular co-ordina- 
tion, and finally coma, 
which may prove fatal if 
the dose taken be sufficient- 
ly large. Whilst it may also 
in small doses stimulate the 
spinal cord, in larger quan- 
tities it undoubtedly weakens 
the functions of that struc- 
ture, causing indisposition 
for active exertion, as well 
as actual want of power. 
This has been proved by the. 
experience of campaigns, 
but more especially that in 
Ashantee, where it was found 
that alcohol distinctly di- 
minished the power of bear- 
ing fatigue, and also by 
the experiments of Parkes, 
which showed most conclu- 
sively that 2 or 3 ounce 
doses of spirit given several 
times per diem to a couple 
of healthy men engaged in 
laborious work, caused a 
slight primary increase of 
energy, but a secondary 
well-marked indisposition 
for muscular exertion, with 
actual diminution of bodily 
vigor. Dr. Wilks has also 
drawn attention to a remark- 
able series of cases in which 
8 



1. A moderate quantity 
of alcohol stimulates the 
mental faculties, whilst lar- 
ger doses become narcotic 
and even anaesthetic. In 
chronic nerve debility, as 
neuralgia, we may often re- 
lieve pain by the use of 
stimulants; but these are 
precisely the class of cases 
in which habits of intem- 
perance are most readily 
formed. 

Nothing seems better 
proved than the fact that 
alcohol lessens the capacity 
for active muscular exer- 
tion, and it is therefore well 
to advise sportsmen, sol- 
diers, and others who are 
about to undergo severe 
bodily fatigue, to reserve 
all stimulant until their day's 
work is over, when it may 
be of real service. In the 
Ashantee campaign a ration 
of rum on reaching camp 
at night seemed to revive 
the men after their labors. 

In those cases of chronic 
alcoholic poisoning de- 
scribed by Wilks, we must 
follow his advice, and en- 
tirely cut off all supplies of 
strong drink. 



86 



ALCOHOL. 



paraplegia, with numbness, 
anaesthesia, and violent 
shooting pains, have been 
caused by the excessive and 
long-continued use of alco- 
hol. 

On the sympathetic sys- 
tem the effects are somewhat 
varied ; for although the di- 
latation of certain vascular 
areas must depend on para- 
lysis of these nerves, there 
seems no doubt that, as 
Binz has shown, alcohol in 
inflammatory conditions 
stimulates the sympathetic, 
contracts the arterioles, and 
prevents that migration of 
the white corpuscles which 
constitutes the essence of 
this morbid process. The 
chronic abuse of alcohol 
causes nervous tremors and 
debility, gradually leading 
up to that semi-maniacal 
state known as delirium 
tremens, in which the vic- 
tim is haunted by the con- 
stant presence of spectral 
illusions, preventing sleep, 
and finally wearing him out 
if unchecked. The brain, 
like most of the internal or- 
gans of the body, suffers 
in alcoholism from the con- 
traction of new areolar tis- 
sue pressing upon and ob- 
literating some of the nerv- 
ous elements. 

2 . On Heart and Circula- 
tion. — Alcohol in moderate 
doses has a stimulating in- 



This is, no doubt, one 
explanation of the bene- 
ficial action of alcohol in 
some cases of acute inflam- 
mation. 



II. To its action on the 
circulation, however, we 
must ascribe a good deal of 



ALCOHOL, 



87 



fluence on the heart, and 
dilatation of the peripheral 
vessels and of those of the 
brain is produced. 

In chronic alcoholism we 
find adegenerated condition 
of the larger vessels, known 
as atheroma. 



3. Respiration and Tem- 
perature. — The old observa- 
tions of Liebig seemed to 
show that alcohol was a res- 
piratory food, and was 
largely burnt off in the 
lungs, thus aiding in the 
production of animal heat. 
It is now found, however, 
that under its use the car- 



the beneficial influence of 
alcohol in the treatment of 
disease. When the powers 
of life show signs of failing, 
when the first sound of the 
heart grows weak, the pulse 
feeble, compressible, and 
irregular, when syncope 
threatens, and delirium is 
beginning, the indications 
for the administration of al- 
cohol are complete, and it 
will be found to act well 
when the tongue moistens, 
the pulse gains in volume 
and regularity, sound re- 
freshing sleep is obtained, 
and the temperature falls. 
It is, of course, difficult to 
lay down exact rules as to 
the precise stage of fevers 
at which we may best pre- 
scribe alcohol, but ordina- 
rily we should do so in ty- 
phus about the seventh day, 
in typhoid the twelfth, in 
smallpox when the second- 
ary fever is developed, and 
in acute inflammations, gen- 
erally, when the heart begins 
to fail, and the nervous sys- 
tem to show indications of 
debility. 

III. This lowering of 
temperature must also be 
explained by diminished tis- 
sue metamorphosis, and by 
a partial arrest of the oxy- 
gen-bearing function of the 
red corpuscles of the blood. 
It is therefore evident that 
we must warn persons about 
to be exposed to severe cold 



88 



ALCOHOL. 



bonic acid given off from 
the lungs is diminished, and 
that the body heat is lowered. 
When but small doses are 
taken, only a slight cooling 
effect is produced, whilst 
large quantities may reduce 
the temperature by two or 
three degrees, the explana- 
tion being partly that the 
dilatation of the cutaneous 
vessels enables more blood 
to be removed from the 
heat-producing centres, 
spread out and cooled in 
the wide sheet of the super- 
ficial circulation, and then 
returned, to abstract more 
warmth from the internal 
organs. Another curious 
fact is that alcohol also 
diminishes the power of re- 
sistance to cold ; and this 
has been proved not only by 
the experience of Arctic 
voyagers, but by the follow- 
ing experiment : If we place 
two animals, one of which 
has been dosed with alcohol, 
in a chamber of which the 
temperature has been re- 
duced to io° below freezing 
point, both will speedily be 
benumbed to sleep ; but 
whilst the healthy animal 
will be supported by the 
combustion of its tissues and 
survive the shock, its com- 
panion will perish from this 
heat-producing process 

being interfered with by 
the spirit. 

4. Iniestmal Tract. — In 



of the fallacious nature of 
the old notion that alcohol 
furnishes true warmth. 

There can, however, be 
no doubt that we may often 
alleviate the evil effects of a 
chill by a dose of spirit [es- 
pecially in the form of a hot 
toddy], which releases the 
capillaries of the skin from 
their state of morbid con- 
traction, and thus prevents 
congestion of internal or- 
gans. 



IV. Alcohol is often bene- 



ALCOHOL. 



8 9 



small doses, alcohol stimu- 
lates the appetite and in- 
creases the supply of gastric 
juice ; but if given in larger 
quantities, this secretion is 
checked, nausea is produced, 
and the desire for food dis- 
appears. In the advanced 
stages of chronic alcoholism, 
the stomach is injured by 
the contraction of the new 
areolar tissue obliterating 
its glands, and hence we 
find dyspepsia with morning 
vomiting a very common 
symptom in drunkards. 

5. Secreting Organs. — 
Alcohol stimulates the liver, 
and this organ is one of the 
first to suffer from chronic 
abuse of stimulant, the are- 
olar tissues being irritated, 
and an increased formation 
taking place, which gives a 
primary enlargement to the 
organ. These newly formed 
structures, however, having 
the tendency to shrink or 
contract, gradually obliter- 
ate the true secreting ele- 
ments of the gland, which 
grows smaller and harder, 
ascites eventually following 
from pressure on the portal 
vein and obstructed return 
of blood from the abdomi- 
nal circulation. 

Kidneys. — Alcohol has no 
specially well-marked effect 
on the urinary secretion, but 
the kidneys may also suffer 
from the cirrhotic degene- 
ration just described. 



ficial in the case of weakly 
persons, and more especially 
at the extremes of life, by 
giving tone to the digestive 
organs and aiding the due 
assimilation of food. Al- 
though its use is by no means 
essential to the healthy, it 
is of great service to dwellers 
in large towns, and others 
whose mode of life involves 
much mental strain. [Spirits 
should never be taken into 
an empty stomach, but 
should be accompanied by 
food.] 



8' 



90 ALCOHOL. 

Mode of Elimination. 

Alcohol very rapidly enters the blood, and is rapidly 
given out, in small part at least, by the breath, but it prob- 
ably 'undergoes combustion to a great degree in the body, 
maintains or increases the body weight, and prolongs 
life on an insufficient diet. It is therefore entitled to be 
reckoned as a food' (Brunton). Much discussion has 
been expended on its elimination or otherwise, and some 
years ago the hopes of temperance agitators were much 
raised by the apparent result of experiments put forward 
by two French observers, which seemed to prove that all 
the ingested alcohol is given out unchanged in the uri- 
nary secretion. Anstie and Dupre, however, showed the 
fallacy of this by pointing out that even the urine of the 
most rigid abstainers contains a substance which cannot, 
by the chromic acid test, be distinguished from acohol, 
and it has since been asserted that this may actually be 
alcohol derived from converted liver sugar. The most 
recent researches of Binz seem to establish the conclu- 
sion that, unless the quantity of spirit taken be very large, 
little or none is really eliminated by the urinary secretion. 

As regards the dose of alcohol it is manifestly impossi- 
ble to lay down any hard and fast rules, as we must of 
necessity be guided by the constitution of the patient and 
the symptoms of his special case. As a rule we may say 
that about 8 oz. of brandy may be sufficient in typhus or 
any acute illness, and that 16 oz. may be looked upon as 
the quantity which it is well not to exceed. In a state of 
health, 2 oz. of absolute alcohol per diem is usually con- 
sidered a maximum allowance. But we must always re- 
member the golden maxim, never to permit stimulants to 
enter the stomach save in combination with food. 

It is of some importance to consider the forms of alco- 
hol best adapted for varying cases, and we may say, gen- 
erally, that champagne acts well in sudden and rapid sink- 
ing, whilst good whiskey or brandy may be recommended 
in ordinary acute illness. Port and Madeira are well 
suited for cases of debility ; and in convalescence from acute 
illness and digestive feebleness, malt liquors and Burgundy 
will often be found to be of great service ; but we must 
always beware of the possibility of leading our patients 



AMYLIC ALCOHOL. 91 

into disastrous habits of self-indulgence by a lack of pre- 
cision in our directions as to quantity. 

[By the action of sulphuric and nitric acids upon 
stronger alcohol, nitrous ether is produced, which in com- 
bination with alcohol is called — ] 

SPIRITUS ^ETHERIS NITROSI. 

This preparation, in doses of from ^ fl. drachm to 
2 fl. drachms, is diuretic and diaphoretic, and is much 
used in feverish conditions. 



[SPIRITUS ^STHERIS COMPOSITUS. 

This is an alcoholic solution of ether, impregnated with 
oil of wine, and is popularly known as Hoffmann's anodyne 
liquor. It is used in hysteria and nervousness. Dose 
f 5ss.-ij. 

Spiritus. 

The officinal spirits are : — 
Spiritus iEtheris Compositus Spiritus Juniperi Compositus 



" Nitrosi ' 


' Lavandulae 


Ammoniae ' 


' " Comp 


" Aromaticus ' 


' Limonis 


Anisi ' 


f Menthae Piperitse 


Camphorae ' 


1 " Viridis 


Chloroformi ' 


' Myrciae 


Cinnamomi ' 


' Myristicae 


Frumenti ' 


' Vini Gallici.] 


Juniperi 





[ALCOHOL AMYLICUM— AMYLIC ALCOHOL. 

Syn. Fusel Oil. 

A peculiar alcohol obtained from fermented grain or 
potatoes by continuing the process of distillation after the 
ordinary spirit has ceased to come over. U. S. 

Amylic alcohol is an active irritant poison, for which 
no direct antidote is known. 

Officinal Preparations, U. S. 

Ammonii Valerianas and Quinise Valerianas. 

In addition to valerianic acid and its salts, amylic alco- 
hol is used in the manufacture of the non-officinal nitrite 



9 2 



AMYL NITRIS. 



of amyl, which has become of sufficient interest to war- 
rant extended notice. It has come into general use, 
although not yet accepted by the Pharmacopoeia.] 



AMYL NITRIS. 
[Not Officinal.] 



Local Action. 

Nitrite of amyl is not possessed of any local irritant or 
sedative propeities. 

Internal Actions. 



Physiological. 

I. Nervous System. — i. 
On Brain. — No special ef- 
fect is produced on this or- 
gan beyond that resulting 
from dilatation of the cere- 
bral vessels, and consisting 
of a sensation of fulness and 
oppression in the head. 



2. On Spinal Cord. — A 
distinct lowering of reflex ir- 
ritability has been observed. 



II. Vascular System. — i . 
On Heart. — After a brief 
inhalation of this drug, the 
action of the heart becomes 
excessively rapid, the face 
flushes, and a violent throb- 
bing in all the arteries is ex- 
perienced; and if its admin- 
istration is pushed up to 



Therapeutical. 

I. — i. It has been recom- 
mended as a remedy for epi- 
lepsy, in virtue of its dilating 
powers releasing the vessels 
of the brain from that con- 
dition of partial spasm which 
is said to be the cause of the 
disease. There is at present, 
however, no satisfactory cli- 
nical evidence in its favor. 

2. It has been theoreti- 
cally recommended in cases 
of tetanus and strychnia poi- 
soning, and in neuralgia its 
inhalation has apparently 
been followed by relief. 

II. — i. The nitrite of amyl 
has been proposed as an an- 
tidote in chloroform poison- 
ins:. 



AMYL NITRIS. 



93 



poisonous limits, there is 
much weakening of the car- 
diac pulsations. 

2. The effect on the arte- 
rial system is one of marked 
dilatation, the vessels enlarg- 
ing, as proved not only by 
general flushing, but by con- 
gestion of the retina, and by 
the free flow of blood from 
cupped surfaces which had 
previously yielded only a 
few drops. The arterial ten- 
sion becomes much lowered, 
and this enlargement of the 
calibre of the vessels has 
been proved to depend on a 
direct action of the drug on 
the muscular coats of the ar- 
teries, and not on any inter- 
vention of the vaso-motor 
system. 

It has also been proved 
that oxidation is diminished, 
that the haemoglobin of the 
blood is checked in its func- 
tion of absorbing and giving 
up oxygen, and that, pre- 
vious to death, the color of 
the arterial and venous blood 
becomes almost precisely 
alike. 

III. On Respiration and 
Temperaticre. — During the 
early stage of amyl inhala- 
tion the respiration is hur- 
ried, but when the adminis- 
tration is further pushed the 
breathing becomes slower, 
and finally extinguished, 
from the arrest of the cor- 
puscular action noted above, 



2. In consequence of this 
dilating effect on the vessels, 
amyl has been most success- 
fully used in angina pectoris. 
The essential condition here 
is supposed to be one of 
spasmodic contraction of the 
smaller pulmonary and sys- 
temic vessels, against which 
the heart, generally weak- 
ened, as it is in this disease, 
by mal-nutrition of its mus- 
cular structures, finds itself 
unable to cope, and hence 
the agonizing distress. In- 
halation of the drug releases 
the spasm, and so gives ease; 
and this result follows whe- 
ther there be actual valvular 
disease or not. 



III. Amyl has been suc- 
cessfully used during the pa- 
roxysm of spasmodic ast/ima, 
acting, no doubt, by relaxing 
the muscular walls of the 
bronchial tubes. 



94 GARLIC. 

and from a paralyzing effect 
on the respiratory nervous 
centre. The temperature 
tends to fall, from the dimi- 
nution in the process of oxi- 
dation. 

IV. On the Digestive Sys- IV. Amyl has been the- 
tem. — The presence of sugar oretically recommended in 
in the urine has been ob- cholera, but there is no spe- 
served during amyl inhala- cial evidence in its favor, 
tion, this being probably 
due to dilatation of the he- 
patic vessels. 

Amyl is now known to act more speedily and effectually 
when inhaled than when taken by the mouth, and from 2 
to 5 drops placed on a handkerchief are cautiously drawn 
into the lungs until the characteristic flushing is produced. 

No special accidents are recorded as having arisen from 
its use ; but the caution seems a reasonable one, not to 
recommend it rashly to old persons with brittle or calca- 
reous arteries, as the sudden alteration of calibre might be 
attended with danger. Possibly also it might be advisa- 
ble not to recommend it to very plethoric patients, whose 
brains are already fully filled with blood. 

Anaemic patients seem to be specially tolerant of its use. 



[ALLIUM— GARLIC. 

The bulb of Allium sativum, U. S. {Dose of the fresh bulbs 5j--ij-) 

Officinal Preparation, U. S. 

Syrupus Allii. Dose f 3j. (for an infant nrv.-x.). 

Garlic is a stimulating expectorant, and is used with 
good effect in the latter stages of catarrhal bronchitis, or 
suffocative catarrh in young children, in which cases it 
may also be used as a poultice to the chest. These poul- 
tices composed of the fresh bulbs pounded into a mass, 
used either alone or with an equal quantity of linseed meal, 
may also be used in infantile convulsions, applied to the 
back and legs, or the oil of garlic may be used as a rubefacient. 



ALOES. 95 

The following would be an appropriate formula for the 
catarrhal bronchitis of infants : — 



u. 


Syr 


Aim 




fSi-; 




<( 


Ipecacuanhae 




f5*ij. 




<( 


Tolutani 




f5v.5 




a 


Acacise 




■ fSyj-j 




Tinct. opii camphorata 


q- 


s. ad f^iij. 


M. 


S. 


Dose TT|_xx to f 3j.] 







ALOE— ALOES. 

[Aloe Barbadensis, Barbadoes Aloes. The inspissated 
juice of the leaves of Aloe vulgaris, U. S. 

Aloe Capensis, Cape Aloes. The inspissated juice of 
the leaves of Aloe spicatae, and of other species of Aloe. 

Aloe Socotrina, Socotrine Aloes. The inspissated juice 
of the leaves of Aloe Socotrina. 

Officinal Preparations, U. S. 

Aloe Purificata, purified aloes. Dose gr. v.-x. 

Pilulse Aloes. (Aloes and soap, aa i part.) 2 grs. 
aloes in each pill. 

Pilulse Aloes et Assafcetidse. (Aloes, assafcetida, 
and soap, aa 1 part.) ij/3 grs. aloes in each pill. 

Pilulse Aloes et Mastiches. (Aloes 4 parts, mastic 
and rose, aa 1 part.) 2 grs. in each pill. 

Pilulse Aloes et Myrrhae. (Aloes 4 parts, myrrh and 
aromatic powder, aa 1 part.) 2 grs. in each pill. 

Pilulse Rhei Compositse. (Aloes gr. jss., rhubarb 

gr. ijO 

Pulvis Aloes et Canellse. (Aloes 4 parts, canella 1 
part.) 

Tinctura Aloes. (gss. to Oj.) Dose fjj.-iij. 

Tinctura Aloes et Myrrhae. (aa 3 jss. in Oj.) Dose 

f3i.-ij. 

Tinctura Benzoini Composita. Dose n^x.-xxx. 

Vinum Aloes (aloes, cardamom, and ginger, in sherry 
wine). Dose f5j. 

Suppositoria Aloes. Each containing gr. ij. of puri- 
fied aloes.] 

Physiological Action. Therapeutical Action. 

Aloes acts on the lower Aloes is a very certain, 
part of the large intestine, efficient, and mild purga- 



9 6 



ALOES 



stimulating its peristaltic 
movements, and causing the 
evacuation of formed and 
only slightly softened faeces. 
It also increases the secre- 
tion of bile, and some au- 
thorities hold that its purga- 
tive action is merely second- 
ary to this. A good deal of 
congestion about the rectum 
is produced, and a sympa- 
thetically stimulating effect 
may extend to the uterus, 
and tend to excite its func- 
tions. 



tive [in doses of ten to 
twenty grains], acting, how- 
ever, rather slowly, and 
seldom producing its effect 
before from six to twelve 
hours. 

It occasionally, however, 
gripes, and is therefore 
usually given in combination 
with other remedies which 
diminish this tendency, and, 
from its action on the lower 
bowel, it must be avoided in 
any local inflammatory con- 
dition, or in the acuter forms 
of haemorrhoids. 

Its mild and slow action 
has caused it to be much 
used in dyspepsia ; it forms 
a principal constituent of 
most dinner pills ; and it is 
also a popular remedy in 
habitual constipation. It 
has also emmenagogue 
properties, depending part- 
ly, no doubt, on the sympa- 
thy of contiguity ; and in 
the form of pill or decoc- 
tion, and given, as laid down 
by Graves, at the time when 
the catamenia are naturally 
expected, it often proves 
most efficient. [The puri- 
fied aloes should be used, 
as the commercial aloes 
contains impurities.] 



Dose, &c. 

The most useful preparations of aloes are, the compound 
decoction, dose f^j. to f^ij.; 1 the pil. aloes et myrrhae ; 
and aloes and iron, dose 5 to 15 grains. 

1 [This is a favorite preparation of the British Pharmacopoeia. It 



MARSHMALLOW — ALUM. 



97 



TALTH^EA— MARSHMALLOW. 

The root of Althcea officinalis, U, S, 

Marshmallow is a demulcent, as it contains chiefly 
mucilage and starch. It is occasionally exhibited as a 
decoction in fevers, or in inflammation of mucous mem- 
branes. In the form of a confection it is popular as a 
pectoral.] 



ALUMEN— ALUM. 

[Aluminii et Ammonii Sulphas, U. S. 
Alumen Exsiccatum. Dried alum.] 

Local Action. 



Alum. 



Physiological, 

Alum, used externally, 
tends, like most astringents, 
to contract the blood-vessels 
and condense the tissues by 
coagulation of their albu- 
men. 



Therapeutical. 

It is therefore much em- 
ployed as an astringent lotion 
in conjunctivitis, leucorrhcea, 
gonorrhoea, and as a gargle 
in sore throat. [Dried alum 
is a mild escharotic for exu- 
berant granulations, etc.] 



Internal Actions and Uses. 



i. On Nervous System. — 
Alum seems to have some 
power in relieving spasmodic 
action. 



2 . Circulation. — This, no 
doubt, is intimately connect- 
ed with No. i, as the con- 



i. It is therefore beneficial 
in some cases of whooping- 
cough, and in colica pictonum. 
[In whooping-cough it is 
given in small doses — gr. j. 
-ij. — in syrup and water 
several times daily. It is 
also one of the best direct 
emetics in croup. Dose 3ss. , 
repeated every half-hour if 
necessary.] 

2. Alum has been used 
for internal haemorrhage, and 
to check excessive sweating, 



contains aloes, licorice, carbonate of potassa, myrrh, saffron, and tinc- 
ture of cardamom, and is gently cathartic. Suppositories of aloes are 
used against ascarides.] 

9 



98 AMMONIAC. 

traction of the blood-vessels and its action in whooping- 

and internally astringent ef- cough is also largely due to 

fects which follow the use of its astringent properties, as 

alum are probably depend- it is most useful in the later 

ent on nervous influence. stages, when profuse secre- 
tion has been established. 

3. On Secretion. — Alum 3. This also explains its 

occasionally acts both as an use in colica pictonum. 
emetic and as a purgative. 

Dose. 

In lotion, gr. ij. ad x. : — 

R. Aluminis gr. x. ; 

Aquae rosae f^iv. M. 

Lotion in catarrhal ophthalmia. 

Internally, gr. x. ad xx. : — 

J£. Aluminis 5'j- > 

Acidi sulphurici dil. 15J- > 
Syrupi limonis i"§ j . j 

Aquae ff'ij- 

M. Dose f 5jss. secunda quaque hora. 

In colica pictonum. 

As purgative, gr. xl. ad lx. 

[Dried alum may be given in pill (gr. ij.) in h<zmoptysis.~\ 

[Aluminiiet Potassii Sulphas. Potassa-Alum, U. S. 
Aluminii Sulphas. Sulphate of Aluminium, U. S. 

The potassa-alum has the same medical properties as the 
officinal alum, just considered, and, in fact, was the Alu- 
men of the Pharmacopoeia in the edition of i860. 

The sulphate of aluminium is antiseptic and astringent. 
It has been used to fill carious teeth, and in solution is 
employed to inject and preserve subjects for dissection.] 



[AMMONIACUM— AMMONIAC. 

A gum-resinous exudation fro??z Doretna Ammoniacum, U. S. 

Officinal Preparations, U. S. 

Mistura Ammoniaci. Dose f gss. 

Pilulae Scillse Gompositse. Dose pills i.-ij. 

Emplastrum Ammoniaci. 

Emplastrum Ammoniaci cum Hydrargyro. 



AMMONIA. 99 

Internal Effects. 

Ammoniac may be used in chronic bronchitis with defec- 
tive secretion, but its systemic influence is not very evident. 
It is given in substance (dose gr. x.-xxx.) or rubbed up 
with water so as to form the Mistura Ammoniaci, or milk 
of ammoniac. The pills (each containing squills gr. ss., 
ginger and ammoniac, aa gr. ij. with soap) are expectorant 
and stimulating. The plasters are resolvent and mildly 
counter-irritant, being useful in enlarged joints and scrofu- 
lous tumors.] 



AMMONIA— AMMONIA. 
[Officinal Preparations, U. S. 

Aqua Ammoniae Fortior. (About 26 per cent, of 
Ammonia.) 

Aqua Ammoniae. (About 10 per cent, of Ammonia. ) 

Linimentum Ammoniae. (Aq. Amnion. ^3, oil 2 /z.) 

Liquor Ammonii Acetatis. Dose f ^ss.-j. 

Spiritus Ammoniae. Dose ttl x.-xv. 

Spiritus Ammoniae Aromaticus. Dose f 3ss.— j. 

Tinctura Guaiaci Ammoniata. Dose f 5j. 

Tinctura Valerianae Ammoniata. Dose f 3j.-ij. 

Aluminii et Ammonii Sulphas (Alum). 

Ammonii Benzoas. Dose gr. x.-xx. 

Ammonii Bromidum. Dose gr. x.-xv. 

Ammonii Carbonas. Dose gr. x. 

Ammonii Chloridum. Dose gr. v.-xx. 

Ammonii Chloridum Purificatum. Dose gr. v.-xx. 

Ammonii lodidum. Dose gr. v.-x. 

Ammonii Nitras (used in making Nitrous Oxide.) 

Ammonii Sulphas (used in making Ammonio-ferric 
alum). 

Ammonii Valerianas. Dose gr. ii.-v. 

Cuprum Ammoniatum. Dose gr. ^-^. 

Ferri et Ammonii Citras. Dose gr. v.-x. 

Ferri et Ammonii Sulphas. Dose gr. iij.-x. 

Ferri et Ammonii Tartras. Dose gr. x.-xxx. 

Hydrargyrum Ammoniatum, used in ointment. 

Antidotes. 
The vegetable acids.] 



IOO 



A M M O N I A . 



Local Action. 



Physiologica L 
The stronger preparations 
of ammonia are irritating to 
the skin, causing redness and 
speedy vesication on account 
of their power of dissolving 
the cuticle. 

Chloride of ammonium, 
on the other hand, is rather 
soothing, and cools the skin 
by aiding the speedy evapo- 
ration of fluids. 

The vapor of ammonia is 
stimulant and irritating. 



Therapeutical. 

Ammonia is therefore a 
component part of many 
stimulating liniments, and is 
an excellent counter-irritant 
and vesicant. It is a good 
application to the sting of 
insects or the bite of poison- 
ous snakes. 

Chloride of ammonium 
used to be an invariable in- 
gredient in evaporating lo- 
tions. 

Ammonia is used by inha- 
lation in syncope, and as an 
aid in the restoration of per- 
sons poisoned by prussic 
acid ; but care must be taken 
not to allow its vapor to 
enter the air-passages too 
freely during unconscious- 
ness, or serious inflammation 
may be produced. 



Constitutional Actions and Uses. 



I. On Brain and Nervous 
System. — The preparations 
of ammonia, generally speak- 
ing, are stimulant in their 
action, affecting, however, 
rather the ganglionic and 
spinal systems than the brain 
proper, and thus differing 
from alcohol. 



Ammonia in its vari- 
ous preparations is very 
largely used as a stimulant 
in many cases of exhaustion 
and debility. It is the best 
means of combating the de- 
pressing influence of snake- 
bite j it is invaluable in bron- 
chitis, pjieumonia, and all 
typhoid conditions, being 
more diffusible and less stu- 
pefying than alcohol ; whilst 
in prussic-acid poisoning it 
may be administered inter- 
nally as well as externally. 



AMMONIA. 



IOI 



Chloride of ammonium 
has, according to Anstie, the 
property of giving increased 
tone to sensory nerves. 



II. Circulation and Respi- 
ration. — Ammonia increases 
the force and frequency of 
the heart's action, this ex- 
plaining some part of its 
stimulating influence. It 
may also aid the respiratory 
power by giving tone to the 
muscular fibres surrounding 
the bronchial tubes. 

When injected into the 
blood, ammonia has the 
power of dissolving the red 
blood corpuscles [perhaps, 
to a moderate extent. But 
the chief source of danger 
after intra-venous injection 
lies in its power of interfering 
with the function of the 
blood-cell as an oxygen car- 
rier. In cases of fatal am- 
monia poisoning the blood, 
after death, is found to be 
dark and to contain very 
little oxygen, nor will it ab- 
sorb the gas and become 
arterialized when agitated 
in an atmosphere of pure 
oxygen. The red blood- 
corpuscle is also found to be 
altered and to show unusual 
resistance to the action of 
acetic acid.] And it is also 
supposed to diminish the 
coagulating property of the 
blood and to assist in the 



Chloride of ammonium is 
very serviceable in many 
cases of neuralgia, and in 
those wearing muscular pains 
in hard-worked women and 
others usually described un- 
der the term myalgia. 



It has therefore been used 
with success by Richardson 
in those cases where, as after 
delivery, diphtheria, ovari- 
otomy, &c, a clot is forming 
in the heart, and he recom- 
mends it by injection into 
the veins, stopping short of 
solution of the red corpus- 
cles. 



102 



AMMONIA. 



solution of fibrinous concre- 
tions already formed. 

III. On Secretion. — Un- 
der this head it may be con- 
venient to place — 

i . The emetic action which 
is specially developed by 
large doses of carbonate of 
ammonia. This effect is also 
produced by injection into 
the blood. 

2. Ammonia increases the 
secretion from the bronchial 
mucous membrane. 



3. Intestinal. — Ammonia 
in large doses increases the 
secretion from the intestines, 
and may cause diarrhoea, 
and it also neutralises acid 
secretions. 

4. Cutaneous. — Ammo- 
nia, more especially in the 
form of liquor ammoniae 
acetatis, acts freely on the 
skin. 

5. Urinary. — No special 
action. 



1. Carbonate of ammonia 
is used as an emetic to assist 
in clearing the air-passages 
from accumulated mucus, 
and in some cases of poison- 
ing. 

2. This, in addition to the 
stimulant action, explains 
the great power of ammonia 
over bronchitis in the weak, 
young, or aged, and the later 
stages of pneumonia, where 
it promotes expectoration 
by thinning and rendering 
the sputa less tenacious. 

3. It is never used as a 
purgative, but this irritating 
action on the bowels may 
render it an undesirable form 
of stimulant in enteric fever. 
It is a useful antacid. 

4. Liquor ammoniae ace- 
tatis is one of our best dia- 
phoretics in a great variety 
of feverish conditions. 



Finally, ammonia has been employed under various 
conditions which cannot conveniently be grouped under 
any precise physiological heading ; but these we will con- 
sider when we refer seriatim to the various preparations of 
the drug. 



Poisonous Action. — If 
given in large quantities, 
ammonia may cause death 
by inflammation of the 



Antidotes. — [Vegetable 
acids and demulcents. The 
fixed oils may be adminis- 
tered, and the usual after- 



AMMONIA. 103 

stomach and intestines; and, treatment instituted for 
according to Richardson, it poisoning by the caustic 
may also kill by dissolving alkalies.] 
the red corpuscles of the 
blood. 

Mode of Elimination. 

Ammonia is very rapidly given out from the system, 
principally by the urine, but also in lesser degree by the 
breath and sweat. 

Preparations. 

Ammonias liquor fortior [Br.] and liquor ammonise [Br.]. 
These are seldom used internally, but occasionally as men- 
tioned above, by vapor and injection. Dr. Halford, of Aus- 
tralia, has also proposed the employment of ammonia in this 
way to neutralize the poison of snake-bites ; but, unfor- 
tunately, wider experience has not confirmed the promise 
of his earlier researches. Dose by injection, from 10 to 
20 minims. 

Ammoniae carbonas. This is the most active and effi- 
cient preparation, used as a stimulant in doses of from 3 
to 10 grs., as emetic 30 grs. Some authors have looked 
upon ammoniae carbonas as a specific for scarlet fever, but 
of the soundness of this view no sufficient evidence has 
been produced. It is nauseous and pungent, and must be 
well disguised, milk being a good vehicle. 1 

I£. Ammonise carbonatis gr. xl. ; 

Tinctune scillse f 5ij. ; 

Syrupi tolutani f^iij.; 

Infusi senegae f^ v U- 

Misce, fiat mistura. Capiat unciam unam quarta quaque 

hora. 

Stimulating expectorant. 

Spiritus ammonise aromaticus. Dose f Jss. to f 3j- This 
contains nutmeg, lemon, and spirit in addition to the 
ammonia. 

Ammonii chloridum. Used as a tonic in neuralgia in 
doses of from 20 to 30 grs. ; but it is very nauseous, re- 
sembling sea water in flavor. 

1 [Carbonate of ammonia must not be prescribed in combination 
with syrup of squill or syrup of garlic, as they contain acetic acid.] 



104 NITROUS OXIDE GAS. 

&. Ammonii chloridi 5U- > 

Ext. glycyrrhizoe §ss. ; 

Syrupi tolutani f §j. ; 

Aq. cirmamomi ad ffviij. 
M. §j. quartis horis. 

In neuralgia. 

It has also, but with little real foundation, been sup- 
posed to possess some power of absorbing lymphatic and 
glandular enlargements, and has been regarded as a good 
remedy in chronic liver disease. 

Ammonii bromidum seems to have an occasional and 
uncertain influence over whooping-cough, and is thought 
by some to be a good substitute for bromide of potassium 
in epilepsy and other nervous disorders. Dose 10 to 20 grs. 

Liquor ammonias acetatis and liquor ammoniac citratis. 
Diaphoretic in doses of from f5ij. to f 3j. 

R. Liq. am. acetatis f §ij. ; 

Syrupi limonis f ^j. ; 

Sp. oeth. nit. f 5iij. ; 

Infusi serpentarias adi^viij. M. 
Dose f §j. quartis horis. 

Diaphoretic mixture. 

Ammonias benzoas, ammonias nitras, and ammonias 
phosphas are seldom if ever used. 

NITROUS OXIDE GAS. 

(Not Officinal.) 
[Made from nitrate of ammonia by heat.'] 

Physiological Action. Therapeutical Action. 

Nitrous oxide, or the old Nitrous oxide gas is very 

laughing-gas, has been valuable for the performance 

recently introduced as an of such small operations as 

anaesthetic, a very brief tooth extraction ; but anass- 

inhalation causing perfect thesia cannot safely be kept 

insensibility, preceded oc- up long enough to render it 

casionally by slight excite- available during more pro- 

ment, and attended by an longed surgical manipula- 

amount of lividity which at tions. During its adminis- 

first sight seems most alarm- tration we must rigidly ex- 

ing. It has been shown elude all atmospheric air, 

that this insensibility is and thus prevent those vio- 

simply a condition of modi- lent and varied evidences 

fied asphyxia, as during of excitement which have so 



ALMOND STARCH. 105 

narcosis only two-thirds of often caused amusement 
the normal amount of car- during the old-fashioned 
bonic acid is given off, and inhalation of laughing-gas. 
immediately after recovery 
only one-third. 



AMYGDALUS— ALMOND. 

[Amygdala Amara. The kernel of the fruit of Amyg- 
dalus Communis, variety amara, U. S. 

Amygdala Dulcis. The kernel of the fruit of Amyg- 
dalus Communis, variety dulcis, U. S. 

Officinal Preparations, U. S. 

Mistura Amygdalae (used as a vehicle). 

Oleum Amygdalse Amarae. Dose gtt. y^ , in emulsion . 

Oleum Amygdalse Expressum (dulcis). 

Aqua Amygdalae Amarae. Dose f^ss. 

Syrupus Amygdalae (Orgeat syrup). Dose f 3J- to 3ss. 

Unguentum Aquae Rosae (from oil of sweet almonds). 

Antidotes. 

The antidotes to poisoning by the preparations of bitter 
almonds are the same as those of hydrocyanic acid.] 

The bitter almond, being uncertain and dangerous, is 
never used in medicine ; but sweet almonds, in the form 
of the mixture or powder, are of value as agreeable vehi- 
cles for the mixture or suspension of other drugs, and Dr. 
Pavy has taken advantage of their nutritive properties to 
propose them as a substitute for bread in saccharine diabetes. 

[The effects of the oil of bitter almonds upon the system 
are identical with those of hydrocyanic acid, upon the 
presence of which its activity depends, but it is about four 
times the strength of the officinal Acidum Hydrocyanicum 
Dilutum. Bitter almond water, and the syrup, are used as 
vehicles for cough mixtures.] 



AMYLUM— STARCH. 

[The feculum of the seed of the Triticum vulgar e, U. S. 

Starch is used medicinally as an antidote to iodine, or 
as a demulcent in corrosive poisoning. In the form of a 
dusting powder it is applied to the skin of infants to pre- 
vent chafing or excoriation.] 



Io6 ANISE — CHAMOMILE. 

Starch is a demulcent used with advantage to some irri- 
table conditions of skin in the form of the glycerine of 
starch, and also as a medium for enemata. 



ANGUSTURA— ANGUSTURA BARK. 

[ The bark of Galipea officinalis, U. Si\ 

Cusparia is a light tonic, rarely used. [It has fallen into 
disrepute, from the fact that it was occasionally found to 
be adulterated with nux vomica bark.] 



ANISUM— ANISE. 

\_The fruit of Pimpinella Anisitm, U. S. 

Officinal Preparations, U. S. 

Aqua Anisi. As a vehicle. 
Oleum Anisi. Dose gtt. v.-xv. 
Spiritus Anisi. (Oil f.^j. in Oj.). 

Anise is carminative and stomachic, and is a favorite 
flavoring ingredient in medicines for children.] 

Anise, Fennel, Coriander, Caraway, and Dill are agree- 
able aromatics, stomachics, and carminatives. 



ANTHEMIS— CHAMOMILE. 

\_The flowers of Anthemis Nobilis, U. S. 

Officinal Preparations, U. S. 

Infusum Anthemidis. Dose f^ij. as a tonic; as an 
emetic ad lib. 

Oleum Anthemidis. Dose gr. v.-xv. 

An agreeable aromatic, in small doses it is drunk as a 
tonic, and in large doses the hot infusion is taken as an 
emetic. A poultice is sometimes made of the boiled flow- 
ers.] 

Chamomile has usually been considered a substance of 
no special therapeutic interest, being principally used by 
country people in the form of infusion as a remedy for 
dyspepsia; but within more recent years various German 
authorities, quoted by Phillips, have stated that the oil has a 
powerful lowering action on the reflex irritability of the 
spinal cord, and have proposed its use in cases of strychnia 
poisoning. 



ANTIMONY. I07 

ANTIMONIUM— ANTIMOiNY. 

[Officinal Preparations, U. S. 

Antimonii Sulphuretum — the purified tersulphide 
(used in making the oxide). 

Antimonii Oxidum. Dose gr. ij.-iij. 

Antimonii et Potassii Tartras. Dose gr. T ^ to j. 

Antimonium Sulphuratum (sulphurated antimony). 
Dose gr. j.-xx. 

Antimonii Oxysulphuretum (Kermes mineral). Dose 
gr. ss-j. 

Pilulse Antimonii Compositae. (6 grs. of the mass 
contains one gr. each of calomel and sulphurated anti- 
mony.) Plummer's Pills. 

Vinum Antimonii — gr. ij. ad f £j. Dose gtt. x. ; as an 
emetic fjj. 

Emplastrum Antimonii (Tartrate of Antimony and 
Potassium 1 part in 4). 

Ungaentum Antimonii (do. do. 1 to 4). 

Syrupus Scillse Compositus (contains Tartar Emetic 
gr. j. ad 5j.).] 

Antidotes. 
Emetics, tea, coffee, tannin, stimulants, &c. 

Local Action. 

Physiological. Therapeutical. 

Externally applied, tartar Tartar emetic used to be 

emetic causes redness and extensively employed in the 

inflammation of the skin, form of ointment as a coun- 

followed by an eruption of ter-irritant, but was found 

papules becoming vesicular, occasionally to cause inflam- 

and finally forming pustules mation, and to leave un- 

closely resembling those of sightly scars, 
smallpox. 

Internal Actions and Uses. 

I. Brain and Nervous Sys- I. Its use was originally 
tern. — Tartar emetic under recommended by Graves, 
certain conditions, and more and has been endorsed by 



io8 



ANTIMONY. 



especially when combined 
with opium, exerts a sedative 
influence on the brain. 

When given in poisonous 
doses, paralysis, probably of 
spinal origin, and attended 
with diminished reflex irrita- 
bility, sets in. 

II. Circulation and Respi- 
ration. — Antimony is seda- 
tive in its operation on the 
heart and vascular systems, 
the heart's action becoming 
slow, weak, and finally ir- 
regular, the arterial tension 
lowered, and the pulse soft 
and compressible. The res- 
piration also grows slower, 
and an increased secretion 
takes place from the bron- 
chial mucous membrane. 



Murchison, in the violent 
delirium of typhus, and it has 
also been employed with 
benefit in delirium tremens. 



General muscular relaxa- 
tion is observed. 



II. The depressing influ- 
ence of tartar emetic on the 
circulation caused it to be 
very generally used in for- 
mer years in acute inflam- 
mations, and more especially 
pneumonia; but this practice 
has now been almost gene- 
rally abandoned, as it was 
found that such treatment, 
whilst exerting no real influ- 
ence over the course of the 
disease, tended to reduce the 
strength of the patient, and 
Cause lingering convales- 
cence. Small doses, how- 
ever, are found useful in 
croup \_spasm of the larynx"], 
and in the bronchopneumo- 
nia of children where great 
dyspnoea and fever exist with 
excessive bronchial secre- 
tion, and it is a good gene- 
ral expectorant in asthma, 
[the first stage of] bronchitis, 
&c. 

Its relaxing effects on the 
muscular system were for- 
merly taken advantage of 
for the reduction of hernia 
and dislocations ; but it has 
of course been quite super- 
seded by chloroform and 
other anaesthetics. 



ANTIMONY. 



I09 



III. 



On Secreting Organs. 



1. Stomach and Intestines. — 
Antimony is an effectual 
emetic, its action being slow, 
however, and attended by a 
good deal of depression. It 
acts either when swallowed, 
or by subcutaneous injec- 
tion; but the balance of ex- 
periment goes to show that 
in either case the effect is 
produced by reflex action 
following irritation of the 
nerves of the stomach. Some 
increase of secretion from 
the intestines and consequent 
diarrhoea are occasionally 
observed. 



2. In poisonous doses an- 
timony causes irritation and 
inflammation of the stomach 
and intestines. 

3. Skin. — Antimony has a 
powerful diaphoretic action. 

Poisonous Action. — Death 
may occur from the collapse 
following prolonged vomit- 
ing and purging, or may be 
the result of gastro-intestinal 
inflammation. Post-mortem 
examination of a protracted 
case generally discovers pa- 
renchymatous degeneration 
of the liver and other inter- 
nal organs. 
10 



1. Antimony is too slow 
and depressing an emetic to 
be used in cases of poisoning, 
but it is of service in croup, 
whooping- cough, bronchitis, 
&c, where we wish to relax 
the bronchi and get rid of 
accumulated secretions. 

In former years, when an- 
timony was freely given, 
what was called tolerance 
used to be an interesting 
therapeutic result. That is 
to say, in feverish conditions, 
it was found that large quan- 
tities of the drug might be 
taken without producing vo- 
miting ; and this has been 
explained by the observation 
that antimony, to act as an 
emetic, must previously be 
dissolved in the gastric juice, 
a secretion which is in great 
measure checked during fe- 
ver. 



3. Antimonial wine is a 
common adjunct to diapho- 
retic mixtures. 



iio antimony. 

Preparations. 

Antimonium tartaratum. [Antimonii et Potassii Tar- 
tras.] Dose, j 1 ^ gr. to ^ gr. ; as emetic, i to 3 grs. In the 
bronchitis of children, from ^\ gr. to T \ gr. 

Vinum Antimonii. Dose, 15 to 40 minims. 

Ung. Antimonii tartarati. [Unguentum Antimonii, 
U. S. P.] 

Pulvis Antimonialis. This is the well-known patent 
preparation known as James's powder, which used to be 
more popular than it is now. 

None of the other preparations of antimony have any 
therapeutic value. 

Mode of Elimination, &c. 

Tartar emetic rapidly enters the blood, and is elimi- 
nated by the bile, milk, sweat, urine, as well as the gastro- 
intestinal glands. 

Prescriptions, &c. 

Tartar emetic, on account of its tastelessness, may be 
well given dissolved in simple distilled water; and Ringer 
tells us, and I have amply confirmed his statements, that 
we may do much good, in some forms of acute bronchitis 
in children, by dissolving a grain of the salt in a pint of 
water, and giving a teaspoonful every quarter of an hour 
for the first hour, and then hourly. 

In the case of adults, when we wish to avoid the nau- 
seating effects of the drug, we may best do so by the fol- 
lowing formulae : — 

I£. Antimonii tartarati [Br.] gr. ij. ; 

Acidi hydrocyanici cliluti ir^xxx. ; 

Tincturse [spiritus] lavandulse comp. * f §ss. ; 
Aquse destillatae ad f §vj. M. 

Dose 1 §ss. quartis horis. • 

1^. Liq. opii sed. 2 f5j-; 

Antimon. et pot. tartratis gr. j. ad gr. ij. ; 

Mist, [aquae] camph. f §vj. M. 

Sumat semunciam omni hora donee somnus supervenerit. 

1 [Each dose contains two and one-half minims of dilute hydrocyanic 
acid. This being the case, the first doses should not exceed f 3J. ; nor 
should this be exceeded unless for good reasons.] 

2 [Battley's solution, non-officinal.] 



WATER. Ill 



Highly recommended by Graves and Murchison in the 
insomnia and delirium of typhus fever. 



AQUA— WATER. 

\_Natural water in the purest attainable state, O. S. 

Aqua Destillata. Distilled water.] 

Water, both in its external and internal applications, 
enters so largely into medical practice as well as into 
domestic economy, that we cannot begin our studies 
better than by considering very briefly what is definitely 
known regarding its physiological and therapeutical pro- 
perties. 

Local Action. 

It will be found difficult, if not impossible, to balance 
the physiological and therapeutical actions of water in the 
manner followed generally throughout this work, and we 
shall therefore give a short collective sketch of the influ- 
ence exerted by it on the various functions of the body. 

It is not necessary for us to do more than refer to the 
universal use of water for washing and bathing purposes, 
but a word or two on the physiological effects of cold 
baths is required. We find that the action of the heart is 
increased, the respiration may become panting and irregu- 
lar, the temperature falls, and the destructive metamor- 
phosis of these tissues is augmented, as indicated by an 
increased excretion of urea; occasionally albumen appears 
in the urine, and so much mental shock is produced, more 
especially by sea-bathing, as to render this usually excel- 
lent tonic unadvisable in those of feeble constitution, in 
the very young and old, and in pregnant women, whilst the 
tendency to vascular strain must prescribe caution towards 
those in whom we have any reason to suspect a degene- 
rated state of the arterial system. 

Occasionally, during sea-bathing, the hair falls off, the 
process of digestion becomes impaired, and sleeplessness 
is experienced ; and this, no doubt, arises from the pro- 
cess of tissue destruction not being thoroughly balanced by 
repair. 

As regards the external uses of cold water in medical 
practice, we may refer to the beneficial action of water- 



112 WATER. 

dressing and irrigation in surgery, to cold affusion in 
lary?igismus stridulus, chorea, hysteria, the stupor of fevers 
and drunkenness, and, most of all, to the wonderful re- 
frigerant action of cold baths in cases of abnormally high 
temperatures. 

It is generally held that a fatal result almost inevitably 
occurs in any case where the [bodily] temperature remains 
above 107 [for several days at a time], and until very 
recently we were powerless to check the destructive influ- 
ence of this complication. Within the last few years, how- 
ever, Dr. Wilson Fox and others have shown that we may 
safely and effectually bring down this excessive heat in 
rheumatism, where it principally occurs, by placing the 
patient in a bath at 95 ° and gradually adding cold water 
or ice until 6o° Fahr. is reached. In this way a reduction 
of from seven to twelve degrees may be readily effected, 
but we must remember one practical point, that the 
patient's temperature continues to fall, as much even as 
six degrees, for forty or fifty minutes after he has been 
removed to bed. Four or five baths may be required 
during the first day of treatment, the patient remaining 
immersed during twenty or thirty minutes ; there can be no 
doubt that by watching our cases of rheumatism carefully, 
and adopting this mode of treatment whenever the ther- 
mometer registers more than 105 Fahr., we may save 
many lives. 

The Germans use the cold bath very freely in all febrile 
disorders, but there is no evidence that their success is 
greater than under the treatment pursued in this country, 
which has the merit of being agreeable to the feelings of 
the sufferer. 

Cold packing is an excellent stimulant to the skin, and 
is extensively employed at our hydropathic establishments. 

Warm water is also very serviceable, and we may men- 
tion the soothing action of warm fomentation, the warm 
douche in early joint disease, and the use of the warm bath 
in the convulsive diseases of children, for the relief of 
colic, spasmodic stricture, hernia, gall or renal calculi, 
and in cases of extensive burns or moist- skin diseases, 
employed after the manner of Hebra, whose patients fre- 
quently remain in a state of continuous soaking for days 
together. 

Ice is a most valuable application for relieving pain and 



WA T E R . 113 

checking inflammation in orchitis, bubo, meningitis, &c, 
as well as for the arrest of haemorrhage, and to allay 
thirst and obstinate vomiting. 

Vapor is often used as a soothing and relaxing applica- 
tion in tonsillitis, bronchitis, croup, &c, and, in the form 
of bath, to cause diaphoresis. 

Constitutional Action. 

When water is taken internally, it acts in some measure 
as a purgative by supplying moisture to the faeces ; it pro- 
motes digestion by stimulating the secretion of gastric 
juice, and aiding the passage of peptones into the blood 
(Ringer) ; and it is in some measure a diuretic, increasing 
temporarily the excretion of chloride of sodium, and 
more permanently the elimination of urea, phosphoric and 
sulphuric acids by the urine. It is, of course, the univer- 
sal solvent, and its importance in the animal economy is 
shown by the fact that it constitutes about sixty-eight of the 
hundred parts which build up our entire bodily frame, 
and that five pints are given out from the body of one 
average-sized adult in the twenty-four hours. The urgent 
necessity for its purity is further proved by the leading 
part it has always taken in the spread of epidemics ; for 
not only cholera, but enteric fever, has thus been largely 
propagated, whilst entozoa are thus introduced into the 
system, and the presence of other impurities may give rise 
to dysentery, diarrhoea, goitre, and yellow fever. [The 
most dangerous adulteration of drinking water is that occa- 
sioned by the presence of decaying organic or albumi- 
noid matter. During epidemics of bowel affections, all 
water should be boiled previous to drinking.] Specific 
adulterations also, like lead, have frequently occasioned 
very painful and even fatal attacks of illness. 

But we may derive great benefit in practice from the 
use of some of those very impure waters, deeply impreg- 
nated with various mineral ingredients, which are known 
as mineral waters, and which are met with in such profu- 
sion and variety both at home and abroad. Fashion, no less 
than undoubted success attending their use, has recently 
brought these naturally adulterated waters prominently 
forward, and it is very essential that every practitioner 
should have some knowledge of their chief constituents and 



114 WA T E R . 

the principal health resorts where they can be partaken of 
in greatest perfection. Our present limits, however, will 
only permit a very bare enumeration of the principal 
classes into which mineral waters have been divided. 

ist. We have the chalybeate or ferruginous class, which 
contains iron in varying proportion, in the form either of 
carbonate, as at [Excelsior Rock Spring, Saratoga,] Spa, 
Tunbridge Wells, and Harrowgate ; or of sulphate, as at 
[Bedford Springs, Pa., Fairmount Park, Phila.,] Brighton, 
Isle of Wight, &c. They are possessed of tonic properties, 
and whilst we generally find them best borne as carbonate, 
we must be cautious of their use in very plethoric and full- 
blooded patients. 

2nd. Acidulous or carbonated. These are agreeable 
and sparkling, holding in solution carbonates of lime, 
soda, and magnesia. They are met with at [Gettysburg,] 
Seltzer, and Carlsbad, and are serviceable in gout and dys- 
pepsia. 

3rd. Saline, some of which are purgative by containing 
the sulphates of magnesia and soda, as at [Saratoga, Con- 
gress Spring,] Cheltenham, Leamington, Friedrichshall, 
&c. ; others, as Buxton, Bath, and Bristol, are impreg- 
nated with carbonate and sulphate of lime ; others with 
chlorides, as Weisbaden, Baden-Baden ; whilst a fourth 
class, as at Vichy and Ems, owe their properties to the 
alkaline carbonates which they contain. [Apollinaris and 
Hunyadi Janos waters belong to this class.] 

4th. Sulphuretted or hepatic waters contain sulphuretted 
hydrogen in solution, and possess a very offensive taste and 
smell. They are chiefly met with at Horrowgate, Moffat, 
Cheltenham, Aix-la-Chapelle, [Virginia Sulphur Springs,] 
&c, and are principally used in chronic skin diseases. 

[The class of Aquae in the U. S. Pharmacopoeia includes 
the following: — 

Aqua Acidi Carbolici Aqua Cinnamomi 

" " Carbonici " Creasoti 

" Ammonia? 1 " Destillata 

" Amygdalae Amarse " Foeniculi 

" Anisi " Mentha; Piperita 

" Aurantii Florum " Mentha? Viridis 

" Camphorae " Rosa?.] 

" Chlorinii 

1 [Aqua Ammonii Fortior is included in the primary list, and hence 
does not appear among the preparations.] 



SILVER. 



115 



ARGENTUM— SILVER. 

[Argenti Cyanidum — for making Acidum Hydrocyan- 
icum Dilutum. 

Argenti Nitras. Dose, gr. }&-i]., in pill. 
Argenti Nitras Fusa — for external use. 
Argenti Oxidum. Dose, gr. ss.-ij., in pill. 

Antidote to Nitrate of Silver — Table salt. 

Metallic silver is inert. As it occasions no chemical 
irritation in the tissues, canulae are made of it for use in 
empyema to wash out the chest, &c. Silver wire is also 
used in surgery to unite the fractured ends of bones where 
there is delayed union, and for sutures in wounds of the 
scalp and elsewhere. The salts of silver are best admin- 
istered in pill form, for which gum Arabic is probably the 
best excipient, as with vegetable extracts, or glucose, they 
are apt to explode.] 

Local Action. 



Physiological. 

The nitrate of silver hard- 
ens primarily, but seconda- 
rily destroys the cuticle, and 
condenses the tissues by co- 
agulating their albumen. Its 
application may cause ulcer- 
ation of the healthy skin, 
and checks the activity of 
granulating surfaces. 



Th erapeutical. 

Nitrate of silver, either in 
substance or solution, has 
been used to check the 
spread of erysipelatous in- 
flammation, to arrest the 
pitting of smallpox, and to 
avert the formation of bed- 
sores. 

It is a good injection for 
gonorrhoea, or collyrium for 
conjitnctivitis, and a strong 
solution is one of our best 
remedies for various relaxed 
or ulcerated conditions of 
the fauces. In substance, 
lunar caustic forms a good 
application to simple vene- 
real sores, ulcerated tonsils, 
or to any ulcerating or gran- 
ulating tissue, when we wish 
to repress exuberant granu- 
lations or excite a new and 
more healthy action. 



Il6 ARNICA. 

Internal Actions and Uses. 

Silver is now but little employed internally. It formerly 
enjoyed a certain empirical reputation in the treatment of 
epilepsy and other nervous disorders; but when it was found 
that not only no benefit resulted from its use, but that an 
indelible and peculiarly unsightly bluish-gray discoloration 
was occasionally developed on the skin, it became evident 
that the wisest course in future would be to discard nitrate 
of silver altogether as a constitutional remedy. [The 
oxide has been highly recommended as a nervous sedative, 
and as a haemostatic in menorrhagia.] 



ARNICA— ARNICA. 

\_Thefloivers of Arnica Montanum, U. S. 

Officinal Preparations, U. S. 

Extractum Arnicse. Dose, grs. v.-x. 

Emplastrum Arnicae (extract }£)■ 

Tinctura Arnicse (Sfiij.-Oj.); used externally.] 

External Actions. 

If applied to the skin for Some practitioners value 
some time, arnica causes red- arnica highly for the power 
ness and irritation, and in which they believe it to pos- 
some susceptible subjects sess of absorbing bruises and 
most violent erysipelatous relieving sprains. Dr. Gar- 
inflammation, even ending rod, on the other hand, as- 
in death, has resulted. It serts that any power it seems 
must therefore be used with to exercise in dispersing ex- 
caution, travasations of blood is sim- 
ply due to the spirit which 
the tincture contains. Dr. 
Phillips, again, tells us that 
the irritating effects never 
follow the use of an aqueous 
solution, which contains 
none of the arnicine or vol- 
atile oil. 

Internal Actions. 

The physiological and medicinal actions of arnica can 
only be balanced with difficulty, as the evidence regarding 



ARSENIC. 117 

the former is very conflicting, and the opinions on the 
latter certainly err in the direction of over-confidence. 
As it is rarely, if ever, used as a medicinal agent save by 
homoeopathic practitioners, it does not seem necessary to 
say more about its asserted virtues. 

ARSENICUM— ARSENIC. 

[Acidum Arseniosum. Sublimed arsenious acid in 
masses, U. S. Dose, gr. 2V 

Officinal Preparations, U. S. 

Arsenici Iodidum. Dose, gr. }£. 

Liquor Arsenici et Hydrargyri Iodidi (tt^xx. con- 
tains arsenic gr. j^l) Donovan's solution. Dose, tti^x. 

Liquor Arsenici Chloridi. (Acid, arsen. gr. iv. ad 
f^j.) Dose, nrv. 

Liquor Potassii Arsenitis. (Acid, arseniosum, gr. iv. 
ad f.f j.) Fowler's solution. Dose, n^v. 

Liquor Sodii Arseniatis. (Sodii arseniat. gr. iv. ad 
f^j.) Dose, tti^v. 

Sodii Arsenias. Dose, gr. T ^. 

Metallic arsenic is inert, and is not used in medicine. 
Arsenious acid is sometimes termed white arsenic, or, 
simply, arsenic, as in the following remarks. 

Antidotes. 

The chemical antidotes to arsenious acid are freshly 
prepared hydrated sesquioxide of iron, and magnesia, 
freshly calcined. When Fowler's solution has been taken, 
the ferric salts are the antidotes.] 

Local Action. 

Physiological. Th erapeutical. 

Externally applied, arse- Arsenic has been era- 
nic causes redness and in- ployed as a caustic in cancer 
flammation of the skin, and allied diseases ; but not 
followed by ulceration and only is its action difficult to 
sloughing. regulate, but dangerous 

symptoms of poisoning have 
resulted from the very ready 
way in which it is absorbed 
by the skin. 



n8 



ARSENIC. 



Internal Actions and Uses. 



I . On Brain aiid Nervous 
System. — Arsenic has a tonic 
influence on the nervous 
system generally. 



Secreting 



II. Circulation and Re- 
spiration. — In small doses 
arsenic may stimulate cardiac 
action in a slight degree ; 
and the experience of the 
arsenic-eaters of Styria 
shows that its use improves 
their wind, and enables 
them to undergo great exer- 
tion without fatigue 

I'll. On the 
Organs. — i. Digestive Tract. 
In small doses arsenic stimu- 
lates the appetite and in- 
creases the digestive powers, 
but if used more freely 
symptoms of irritation set 
in, which may terminate in 
gastro-enteritis. [Some pa- 
tients cannot take the 
smallest doses without great 
systemic disturbance. It is 
advisable to begin with 
minute doses and cautiously 
increase, watching the ef- 
fect.] 



I. This may in some 
measure explain its anti- 
periodic properties, for it is 
well known that arsenic is 
only second to quinine in 
its power of arresting the 
various manifestations of 
ague. 

It is also a valuable 
remedy in neuralgia, and 
chorea may frequently be 
cured by full doses. 

II. Arsenic is of service 
in asthma, hay-asthma, and 
some forms of chronic bron- 
chitis. 



III. Ringer recommends 
small doses of arsenic — i. 
In a form of irritative dys- 
pepsia with red tongue and 
prominent papillae, in the 
morning vomiting of drunk- 
ards, and in that variety of 
diarrhcea which leads to the 
evacuation of the bowels 
immediately after eating. 
It is now thoroughly estab- 
lished that the inhabitants 
of Styria eat arsenic to the 
extent of gr. j. to gr. ij., and 
thrive on it, becoming fat 
and ruddy, and that it is 
occasionally given to horses 
with the view of improving 
their coats. 



ARSENIC. 



119 



2. Cutaneous. — Arsenic 
occasionally causes irritation 
and tingling of the skin, and 
even the appearance of ecze- 
matous eruptions. 



3. Liver. — Arsenic in poi- 
sonous quantities causes, like 
phosphorus, fatty or paren- 
chymatous degeneration of 
the liver. 

4. On Urine. — Nothing 
special has been described 
[except that the kidneys are 
the principal channel for the 
discharge of the poison from 
the system.] 

Poisonous Effects. — Poi- 
soning by arsenic is ushered 
in by [burning] pain in the 
stomach, vomiting, diar- 
rhoea, headache, fever, and 
disturbed sleep, followed by 
more acute symptoms and 
death from collapse — a train 
of symptoms much resem- 
bling those met with in cases 
of true cholera. [Such phe- 
nomena occurring in the ab- 
sence of any epidemic of 
Asiatic cholera, and coming 
on soon after eating, in a 
previously healthy person, 



2. In dry scaly affections 
of the skin, such as psoriasis, 
in the dry stages of eczema 
and impetigo, in pemphigus, 
and in lichen, arsenic acts 
most admirably ; but we 
must be careful never to 
give it during the acute 
stage of any skin affection, 
as in these circumstances, 
it is invariably found to 
aggravate the symptoms. 
Arsenic is much valued by 
Balfour and others in chronic 
rheumatism, and more espe- 
cially rheumatoid arthritis. 



Antidotes. — After evacua- 
tion of the stomach, we must 
give light magnesia or the 
[fresh] hydrated sesquioxide 
of iron [followed by castor 
oil to evacuate the bowels. 
The case should then be 
treated on general princi- 
ples]. 



120 ARSENIC. 

should excite suspicion of 
arsenical poisoning.] 

After death, in addition to 
the usual pathological ap- 
pearances of gastro-enteritis, 
we find fatty degeneration of 
the heart and muscles, and 
parenchymatous degenera- 
tion of the liver, kidneys, 
&c. [Arsenic may generally 
be detected in the liver or 
contents of the stomach by 
Reinsch's or Marsh's Test.] 

Mode of Elimination. 

Arsenic is rather slowly removed from the body by the 
intestines, the urine, and perhaps the bile. 

Mode of Administration, Cautions, &c. 

Persons vary much in their susceptibility to arsenic, and 
we must invariably begin its use with caution, keeping in 
mind that children bear it well, and that a child of five 
can bear with impunity as large a dose as an adult. [Two 
grains of arsenious acid has caused death, according to 
Dr. Taylor.] 

We must also remember that, although the Styrian peas- 
ants can accustom themselves to large and increasing doses, 
the experience of medical practice shows that, after a cer- 
tain time, patients taking this drug are liable to show 
some of the following symptoms: — Smarting and itching 
about the conjunctivae, with oedema, pain in the stomach, 
vomiting and diarrhoea, white tongue, and general digestive 
derangement; and when these indications of "accumula- 
tion" occur, it is not necessary to suspend the remedy 
altogether, but merely to diminish the dose. 

The probabilities of these unpleasant symptoms are much 
lessened, however, by advising that the dose should always 
be taken after a meal. 

The mode in which arsenic is usually given is in the form 
of liq. arsenicalis [Fowler's Solution— Liq. Potass. Arse- 
nitis, U. S.], which is merely a solution of arsenious acid 
in carbonate of potash flavored with sp. lavand. co., con- 
taining gr. ss. in f3J-> and of which the dose is, as a general 



ASSAFETIDA. 121 

rule, from rtr.ij. to n^v. ; but in some obstinate affections, 
like chronic rheumatic arthritis, it is requisite to push the 
quantity as far as ttlx. or even ttlxv. Being almost taste- 
less, liq. arsenicalis is best given simply in water. 

The liquor arsenici hydrochloricus, sodse arsenias, and 
ferri arsenias are rarely used, their respective doses being 
2 to 8 minims and ^ gr. to ^ gr. ; and the liquor arsenici 
et hydrargyri hydriodatis [Donovan's Solution], which was 
supposed to have a special influence over syphilitic skin 
diseases on account of its combination of arsenic with 
iodine and mercury, has gone much out of fashion in these 
days. Dose, 10 to 30 minims. [The iodide of arsenic is 
sometimes used as an ointment in skin affections — gr. iij. 

to 3j.] 

ASSAFGETIDA— ASSAFETIDA. 

\_A gum-resinous exudation, obtained by incision from the root of 
Narthex Assafetida, U. S. Dose, gr. v.-x. 

Officinal Preparations, U. S. 

Mistura Assafcetidse (3iv. to Oj.) Milk of Assafetida. 
Dose, f^ss.-j. 

Tinctura Assafcetidae (gij. to Oj.) Dose, fjss.-j. 

Pilulae Assafcetidse (each gr. iij.). Dose, 2 to 4. 

Pilulae Aloes et Assafcetidae (each gr. )Yi). 

Pilulae Galbani Compositae (each gr. y 2 ). 

Suppositoria Assafcetidae (each 5 grains, or ni^xv. of 
the tincture). 

Emplastrum Assafcetidae.] 

Physiological Actions. Therapeutical. 

A good deal of digestive Assafcetida has been used 
disturbance seems to follow and recommended in a con- 
the administration of this siderable variety of affec- 
drug to healthy persons; but tions, but practically it is 
the evidence is too conflict- now only prescribed in flat- 
ing to enable us to lay ulent dyspepsia and in hys- 
down any exact scheme of teria, where its excessively 
its influence on the various nauseous smell and taste are 
functions of the body. supposed to give it an ad- 

vantage over other drugs of 
the same class. 1 

1 [Prof. H. C. Wood states that " assafetida is one of the most efficient 
of the so-called antispasmodics, and may be given to fulfil the same 
11 



122 ORANGE 



AURANTIUM— ORANGE. 

[Aurantii Amari Cortex. The rind of the fruit of 
Citrus vulgaris. 

Aurantii Dulcis Cortex. The rind of the fruit of 
Citrus aurantium. 

Aurantii Flores. The flowers of Citrus aurantium and 
Citrus vulgaris. 

Officinal Preparations, U. S. 

Aqua Aurantii Florum. Used as a vehicle. 
Syrupus Aurantii Florum. Used as a vehicle. 
Confectio Aurantii Corticis. Used as a vehicle. 
Syrupus Aurantii Corticis. Used as a vehicle. 
Tinctura Aurantii. Dose, f3j- _ ij- 
Infusum Gentianse Compositum. Dose, f^ss.-ij. 
Tinctura Cinchonse Composita. Dose, f3j.-ij. 
Tinctura Gentianae Composita. Dose, f3j.-iv.] 

Properties. 

The various preparations of orange require no detailed 
comment, for beyond the fact that those made from the 
rind are mildly tonic in virtue of their bitterness, and that 
the syrup and the orange-flower water are agreeable flavor- 
ing additions to a prescription, we have no evidence of 
their special therapeutic properties, if any exist. [The 
volatile oil of the flowers, obtained by distillation, is 
called, in commerce, oil of Neroli, and orange-flower 
water is hence sometimes termed Neroli water.] 

indications as valerian in functional spasm, in hysteria, and nervous- 
ness. It differs from valerian in having a much more decided action 
upon the mucous membranes. It is an excellent carminative, and in 
the form of injection is constantly used for the relief of ty?npanitis. 
It also in small doses increases the appetite and affords relief in dys- 
pepsia, with flatulent colic and costiveness, of the aged or hysterical. 
As a stimulating expectorant and antispasmodic, it is useful in whooping- 
cough and chronic catarrh. It is especially efficient in palliating the 
latter affection as occurring in old people, when the difficulty of breath- 
ing is paroxysmally increased by spasm of the bronchial tubes. In 
infantile convulsions and in severe infantile colic, assafetida enemata 
(3\j. to §ss. of the milk) are exceedingly useful and harmless." Thera- 
peutics, 2d ed., p. 191.] 



CARBONATE OF BARIUM. 123 

[AVENGE FARINA— OATMEAL. 

The meal prepared from the seeds of Avena Saliva, U. S. 

Extensively used as an aliment in the form of gruel. 
It is nourishing and slightly laxative. Three varieties are 
met with in the Middle States, the Ohio, the Canadian, 
and the Scotch oatmeal ; the latter, being imported, brings 
a higher price, and is considered by some to be better, 
perhaps solely on that account. Its taste is less pleasant 
than the others, which are probably equally as good. 
Thin oatmeal gruel, strained and sweetened, forms a 
valuable and popular infants' food.] 



BALSAMUM PERUVIANUM— BALSAM OF PERU. 

\_A11 empyreumatic liquid balsam obtained from Myrospermum Perui- 

fertim, U. S.~\ 

Local Action. 

Peruvian balsam tends to It may therefore be used, 
check copious and unhealthy like myrrh, as an application 
secretions. to foul and unhealthy sores. 

Constitutional Action. 

Like the other gum bal- It has therefore been pre- 

sams, it acts on the mucous scribed to restrain excessive 

membranes, and more espe- discharges in bronchitis, &c. 

cially on the bronchial tubes. [Dose, fjss. in emulsion.] 



BALSAMUM TOLUTANUM— BALSAM OF TOLU. 

\A semi- liquid balsam obtained from Myrospermum Toluiferum, U.S. 

Officinal Preparations, U. S. 

Syrupus Tolutanus. (Tinct. fsij.toOj.) Dose, f^ss.-j. 
Tinctura Tolutana. (Jjss. in Oj.) Dose, f 5>j- 
Tinctura Benzoini Composita. (Tolu 5ss. in Oj.)] 

This agreeable preparation is almost exclusively used as 
a flavoring addition to cough mixtures, in the form of the 
syrup. 



[BARII CARBONAS— CARBONATE OF BARIUM. 

Only introduced into the Pharmacopoeia in order to 
provide a source for the — 



124 BELLADONNA. 

Officinal Preparations, U. S. 

Barii Chloridum, and 

Liquor Barii Chloridum. Dose, gtt. xxx.-l. 

Antidotes. 
Sulphate of magnesia, or dilute sulphuric acid. 

Internal Effects. 

Barium is only used in medicine in the form of liquor 
barii chloridum, which is recommended by Prof. Gross 
as an alterative in sci-ofula, particularly in cases dis- 
tinguished by a tumid upper lip.] 



BELLADONNA— BELLADONNA. 

[Belladonnas Folia. The leaves of Atropa Bella- 
donna, U. S. 

Belladonnas Radix. The root of Atropa Belladonna, 
from plants more than two years old, U. S. 

Officinal Preparations, U. S. 

Tinctura Belladonnas. (From the leaves, §ij. to Oj.) 
Dose, gtt. x.-xx. 

Extractum Belladonnas. (Inspissated juice of the 
leaves.) Dose, gr. ss.-ij. 

Extractum Belladonnas Alcoholicum. (Of the 
leaves.) Dose, gr. ss.-ij. 

Extractum Belladonnas RadicisFluidum. Dose, Trrij. 

Emplastrum Belladonnas. (From the root.) 

Unguentum Belladonnas. (From ext. belladonnas, 

3J- in 3j.) 

Suppositoria Belladonnas. (From ext. belladonnas 

ale, gr. ss.) 

Atropia. (From the root.) ( Dose, gr. ^, or hypo- 

Atropias Sulphas. { dermically gr. T J^. 

Antidotes. 

Chemical. Fresh animal charcoal, tannin, vegetable 
astringents, &c. 

Physiological. Opium, Calabar bean, tartrate of anti- 
mony and potassa. 

Note. — In the treatment of belladonna-poisoning, the irritating 
emetics, such as mustard, ipecacuanha, and sulphate of zinc, should be 
exhibited to remove from the stomach any excess of the poison remain- 



BELLADONNA. 125 

ing unabsorbed. Apomorphia might be useful hypoclermically (gr. 
^q, repeated). Purgatives containing the chemical antidotes should 
then be given to neutralize any of the drug in the intestines. Symp- 
toms of narcotism should be treated as they arise, by artificial respira- 
tion, douches, counter-irritants, and diffusive stimulants. The physio- 
logical antidotes, being counter-poisons, should be used with the greatest 
care.] 

Local Action. 

Belladonna is used externally, on account of its soothing 
properties, in various forms of neuralgic and rheumatic 
pains, in which cases the liniment, applied either alone or 
in combination with chloroform liniment, often gives re- 
lief. It is also a good application in acute rheumatism, 
placed on cotton-wool and thus encasing the swollen and 
tender joints. Belladonna is also useful, as has been espe- 
cially pointed out by Mr. Heath, in boils and abscesses, 
where the suppurative process may be prevented or even 
arrested by its use. It is also a good application to in- 
flamed piles and fissure of the rectum. It is also applied to 
the skin to check localised sweating, to the breast to arrest 
the secretion of milk, and to the neighborhood of the eye 
to dilate the pupil ; but its actions here are so intimately 
associated with the theory of its internal administration, 
that we will say no more on the subject at present. 

Belladonna is very readily absorbed through the un- 
broken cuticle, and symptoms of poisoning have occasion- 
ally been caused by its local application. 

Internal Administration. 

Physiological Action. Therapeutical Application. 

1. On the Brain. — After i. Belladonna may be 
full doses of belladonna, a cautiously used as a hypnotic 
tendency to delirium sets in, when other remedies fail, 
usually of a joyful character, 

and attended by hallucina- 
tions and spectral illusions. 
Sleep generally follows. 

2. On the Spinal Cord. — 2. It is used in some spinal 
In frogs this action is very affections in accordance with 
decided, for when atropia is the principles of Dr. Brown- 
injected below the skin the Sequard, explained under 
animal is at first paralyzed, another section. 

lying quite motionless, with It is also of value in check- 



11 



* 



126 



BELLADONNA. 



arrested breathing, which 
period of inaction is sud- 
denly interrupted in about 
from one to eighteen hours 
by the occurrence of violent 
tetanic spasms. 

3. Belladonna paralyses 
the terminal filaments of the 
third nerve supplied to the 
circular or sphincter fibres 
of the iris, and thus allows 
the sympathetic, which rules 
over the radiating fibres, to 
come into unchecked play, 
and so dilate the pupil. At 
the same time we observe a 
diminution in ocular tension 
and imperfect vision, espe- 
cially for near objects, due to 
paralysis of the power of 
accommodation. 



ing the tendency which oc- 
casionally exists to noctur- 
nal seminal emissions, when 
these become of exhausting 
frequency. 

3. Belladonna; used more 
conveniently in the cleaner 
form of atropia, is in very 
extensive use in eye diseases 
to facilitate ophthalmoscopic 
examinations, to keep the 
pupil freely dilated in iritis, 
and so lessen the risk of ad- 
hesion of its free margin to 
the lens, with subsequent 
contraction, distortion, and 
impairment of vision. 

It is also used to obviate 
protrusion of the iris through 
any hole in the cornea made 
by ulceration or accident, 
and it forms a soothing ap- 
plication in various painful 
affections. 

To dilate the pupil the 
liq. atropiae [Br., gr. iv. ad 
f 5j] is now generally used, 
care being taken only to in- 
troduce a very small drop 
into the eye ; for if a larger 
quantity is applied, the re- 
sulting effects and inconve- 
niences may last from a week 
to ten days, much to the 
annoyance of the patient. 
[Although weaker solutions 
take a little longer time to 
dilate the pupil and para- 
lyse the accommodation, yet 
these effects are more tran- 
sient and therefore more 
satisfactory to the patient. 
A gr. ^ solution is strong 



BELLADONNA 



I27 



4. The action of bella- 
donna on the sympathetic 
nervous system is somewhat 
irregular, and to this is no 
doubt due some at least of 
that action on certain secre- 
tions which we shall shortly 
note more fully. But one 
symptom often observed, 
more especially in children, 
probably proceeds from va- 
so-motor paralysis, and that 
is transient flushing and 
sweating of the face now 
and then following a dose. 

5. The influence of bella- 
donna on the circulation is 
due to another nervous influ- 
ence. Under the use of this 
drug we observe increased 
rapidity and force of cardiac 
action, and this is explained 
by a paralysing action which 
it exerts on the terminal in- 
hibitory filaments of the 
pneumogastric nerve distri- 
buted to the intimate struc- 
ture of the heart. It is 
proved by experiment that 
the sympathetic nerve sup- 
ply has the power of causing 
very rapid action of the 
heart; but a rein is kept on 



enough for ordinary use, and 
will dilate the pupil in about 
half an hour after instilla- 
tion.] 

Belladonna being so read- 
ily absorbed, however, dila- 
tation of the pupil will ensue 
on application of the extract 
or liniment for any length of 
time to any part of the body. 



5. Belladonna is an excel- 
lent cardiac tonic, increasing 
the regularity and strength 
of the contractions of the 
heart. 

It is also a very soothing 
remedy in cases of irritable 
palpitation, and the old- 
fashioned belladonna plaster 
is certainly of use in these 
conditions. 



128 



BELLADONNA. 



this, and the proper balance 
of motive force is sustained 
by the pneumogastric nerve, 
which inhibits or restrains 
the impetuous action of the 
sympathetic. By paralysing 
these inhibitory filaments, 
then, belladonna hands the 
heart over to the sympa 
thetic, which, without rein 
or drag, runs riot, and we 
accordingly find that exces- 
ive increase in the heart's 
rapidity follows the injection 
of a moderate quantity of 
atropia. 

Coincident with this we 
get raised arterial tension. 

6. Belladonna contracts 
the small vessels, probably 
not from nervous influence, 
but from a direct action upon 
the unstriped muscular fibres 
surrounding the arterioles. 



7. On Respiration. — Bel- 
ladonna tends to increase 
the rapidity of the breathing 
by stimulation of the respir- 
atory centre. 

8. It has the power of 
contracting unstriped mus- 
cular fibre in other situations 
than the arterial tubes. It 



6. Dr. Brown-Sequard re- 
commends the use of bella- 
donna in those cases of chro- 
nic inflammation of the spine 
leading to paralysis, where it 
acts well by contracting the 
vessels and diminishing the 
supply of blood to the affect- 
ed part; and he gives it in- 
ternally, and applies a plas- 
ter along the spine. 

To this contracting influ- 
ence on the small vessels is 
probably due the effect of 
belladonna in checking local 
inflammatory conditions. 

7. Atropia has been re- 
commended as an efficient 
remedy in asthma. 



8. Belladonna is an excel- 
lent remedy for the noctur- 
nal incontinence of urine of 
children ; but in order to do 



BELLADONNA. 



129 



probably does so both in the 
bladder and intestines. 



Action on Secretion. — 9. 
Salivary It checks the sa- 
livary secretion, causing a 
peculiar sensation of dryness 
in the mouth and throat; 
and this is believed to be 
due to a remarkable select- 
ive action on the secretory 
branches supplied from the 
chorda tympani nerve to the 
submaxillary ganglion. 

10. Cutaneous. — Bella- 
donna most effectually ar- 
rests the action of the skin, 
and occasionally under its 
use a vivid red eruption, not 
unlike scarlet fever, breaks 
out. 



any good it must be boldly 
pushed, and I have been 
obliged to give as much as 
fjjss. or even f3ij. of the 
tincture [Ph. B.] before suc- 
cess was attained. 1 

From its tonic influence 
on the muscular structures of 
the intestines, it is an excel- 
lent adjunct to purgative pill 
masses, from *£ to ^ grain 
acting well in combination 
with colocynth ; or, even 
given alone with ext. gen- 
tian se, it will often secure a 
regular action of the bowels. 

It is also very useful by 
relieving spasm, as in colic. 

9. Belladonna has been 
used to check excessive sali- 
vation. 



10. It is an excellent rem- 
edy for undue sweating, whe- 
ther general, as in phthisis 
or rheumatism, or local, as 
about the head of rickety 
children or the feet of some 
individuals. It maybe either 
given in the form of succus, 
extract, or tincture, or bet- 
ter by the subcutaneous in- 
jection of atropia. 



1 [The Tincture of Belladonna, U. S., is about 2^£ times the strength 
of the English preparation. ] 



13° BELLADONNA. 

11. It also checks the se- 11. It is a most valuable 
cretion of the milk, either remedy in cases where in- 
locally or by internal use. flammation threatens in a 

breast, when the child has 
died or cannot suck, and the 
gland becomes congested 
from retention of its secre- 
tion. Here the external 
application of belladonna 
speedily diminishes the red, 
tense, shining aspect, relieves 
the wearing pain, and arrests 
the milk. 

12. On the solid urinary 12. It may therefore be 
constituents no special action recommended as a good di- 
has been noted, but it in- uretic. 

creases the flow, by raising 
the tension in the glomeruli 
of the Malpighian bodies. 

Belladonna is also used under one or two conditions 
which cannot accurately be grouped under any specific 
heading. 

Thus it has been vaunted in whooping-cough, but after 
careful and repeated trials with large and small doses, I 
am compelled to agree with Dr. Kelly that its action in 
this disease is too uncertain to be of much use. But in 
certain forms of spasmodic cough, simulating pertussis, or 
when the cough is merely an occasional loud clanging 
bark, I have derived much benefit from belladonna. In 
epilepsy and chorea it has been tried, but without marked 
success. 

The subcutaneous injection of atropia is said by Dr. 
Anstie to be of great service in lumbago, sciatica, and 
chronic rheumatism, and to be the best of all remedies 
for pain in the pelvic viscera. It has also been recently 
observed that the addition of a little atropia to the ordi- 
nary morphia injection tends to obviate the distressing 
faintness, pallor and nausea, which occasionally mar the 
efficacy of the subcutaneous mode of administering this 
valuable drug. Ringer recommends its use in irritative 
dyspepsia, giving from \ to \ gr. of the extract night and 
morning, and gradually increasing the dose. [A solution 



BELLADONNA. I3I 

of atropia, i in ioo, if applied to an exposed nerve-pulp, 
is said to relieve toothache immediately.] 

Drawbacks to the Use of Belladonna. 

Poisonous Symptoms and Antidotes. — Occasionally the 
use of atropine drops to the eye causes an erysipelatous 
inflammation about the lids and face, and patients often 
complain of the disfigurement and inconvenience arising 
from a widely-dilated pupil. Idiosyncrasy may also here 
be the source of inconvenience, and we may find persons 
affected with dryness of the mouth and throat after very 
small doses. This is always the first indication of the 
physiological action of belladonna, and is followed by a 
peculiar sensation of thirst and feverishness, without 
heightened temperature, rapid pulse and breathing, red 
tongue j the face then flushes, delirium sets in, with great 
weakness, very hurried breathing, convulsions, and finally 
coma, which ends the scene. The antidotes are opium, 
which, within certain limits, is antagonistic to belladonna, 
animal charcoal, the fixed alkilies, which destroy its poison- 
ous properties, and Calabar bean, which has recently been 
shown to be the physiological antidote. 

One curious point about belladonna is that, although so 
poisonous to man, its destructive influence is very various 
on other animals. The carnivora are much more readily 
affected by it than the herbivora, many of whom browse 
on it with impunity. Thus a horse has been known to 
eat eight pounds of the leaves without injury ; blackbirds 
feed freely on the berries; and 15 grains of atropia are 
required to poison a rabbit. 

Dose and Mode of Administration. 

Extractum belladonnas gr. \ to gr. j.; tinct. belladon- 
nas [Br.] Tr^x. ad f5ij. ', succus n^v. to f5ss. Atropia is 
seldom if ever used internally, and -^ gr. would to be a 
safe medium dose. 

It is well to note that children take not only without in- 
jury, but with benefit, much larger doses than adults, and, 
whilst I have seen a woman display well-marked physio- 
logical symptoms after a few 10 minim doses, I have often 
prescribed 20 minims of the [English] tincture for a child 
of two years without anything of the kind. 



I32 BENZOIN — OIL OF BERGAMOT. 

BENZOINUM— BENZOIN. 

\_A solid balsam obtained from Styrax Benzoin, U. S. 

Officinal Preparations, U. S. 

Acidum Benzoicum. (Enters into Tinctura Opii 
Camphoratae.) Dose, gr. x.-xxx. 

Ammonii Benzoas. Dose, gr. x.-xxx. 
Tinctura Benzoini. Dose, f 5ss.— f 5j- 
Tinctura Benzoini Composita. Dose, f3j--ij- 
Unguentum Benzoini. (Adeps Benzoatus, Br.] 

Local Action. 

Physiological. Th erapeutical. 

Tincture of benzoin is a It is therefore occasionally- 
stimulant to raw surfaces, used as an application to 
[Benzoin has the property foul or indolent sores, 
of preventing rancidity in 
ointments, &c, in hot 
weather.] 

Internal Action. 

Benzoin has the stimulat- Benzoin may be pre- 
ing influence on mucous scribed with effect in ad- 
membranes possessed by vanced cases of bronchitis, 
most of the gum-balsams, and in some conditions of 
During its passage through chronic irritation about the 
the blood it becomes con- bladder, 
verted into hippuric acid, It may be conveniently 
and increases in some raea- given in the form of the 
sure the acidity of the urine, benzoate of ammonia. 

R. Tincturce benzoini composite fgvj. ; 

Mucilaginis acacise f §j. ; 

Syrupi zingiberis f §ss. ; 

Aquae menthae piperitse f§ v j- M. 

S. Capiat unciam unam quarta quaque hora. 

For advanced bronchitis. 



[OLEUM BERGAMII— OIL OF BERGAMOT. 

77/,? volatile oil obtained from the fruit of Citrus Limetta 
(Be Candolle), U. S. ' 

Used almost exclusively as a perfume.] 



BISMUTH 



1 33 



BISMUTHUM— BISMUTH. 

[ Commercial bismuth of good quality, U. S. 

Officinal Preparations, U. S. 

Bismuthi Subcarbonas. Dose, gr. xv.-xlv. 
Bismuthi Subnitras. Dose, gr. v.-xxx.] 

Local Action. 



Physiologic a I. 

Bismuth has no action on 
the unbroken cuticle, but, 
applied to a raw or mucous 
surface, it is sedative and 
astringent. 



Th erapeutical. 
It is a good application to 
intertrigo, ulceration about 
the mouth, and as an injection 
in gonorrhoea and leucon'hcea. 
It has lately been recom- 
mended as a snuff to check 
cold in the head, and the 
liquor has been praised as 
an application to prolapsus 
ani (Cleland). 



Internal Actions and Uses. 



On Digestive Tract. — 
Bismuth is sedative to the 
stomach, and exerts an 
astringent influence over 
the intestines, probably in 
virtue of its local effects. 



Bismuth is one of our 
most valued remedies in 
many forms of dyspepsia, 
the main indications for its 
use being pain and vomiting. 
When a patient suffers acute 
pain after eating, with or 
without sickness, the tongue 
being clean and much flatu- 
lence present, we may give 
bismuth with much confi- 
dence, and it is also of ser- 
vice in the vomiting of 
drunkards, m pyrosis, and in 
many forms of diarrhoea, 
more especially that met 
with in children. 



Mode of Elimination. 

Very little bismuth is absorbed, and it is principally 
thrown out of the system by the intestines, to whose secre- 

12 



134 BROMINE. 

tion it imparts a blackish hue, from the formation of a 
sulphide. 

Mode of Administration, &c. 

The subnitrate of bismuth, which is the most effective 
preparation, may be given simply in powder, either by 
itself or in combination with charcoal or soda ; or it may 
be given in solution with hydrocyanic acid, gentian, &c, 
the dose being from 5 to 20 grs., and large doses being 
preferable. 

R. Bismuthi subnitratis 5*1- ; 

Mucilaginis [acacice] f^j. ; 

Acidi hydrocyanici diluti Tr\x.-xx. ; 

Infusi gentianae ad f ^ v j . M. 
Sumat f §ss. ter die. 

R. Liquoris bismuthi et ammonias citratis [Br.] f 5iv. ; 

Syrupi aurantii f ^v. ; 

Infusi calumba; f §v- 

Misce. Sumat unciam unam ter in die. 

The carbonate and oxide of bismuth are seldom used, 
but an agreeable preparation, less effectual, however, than 
the subnitrate, is known as the liquor bismuthi et ammoniae 
citratis, which contains gr. iij. of the oxide to the drachm; 
and lozenges, containing each gr. ij. of the subnitrate, are 
also included in the [British] Pharmacopoeia. 



BROMINIUM— BROMINE. 

\A liquid, non-metallic element, obtained from sea-water. 

Dose, gtt. ij.-iij., largely diluted with water. 
Officinal Preparations, U. S. 

Ammonii Bromidum. Dose, gr. xx.-xxx. 
Potassii Bromidum. Dose, gr. x.-xxx. 

Antidote. 

Ammonia, followed by the customary treatment for 
irritant poisons.] 

Bromine has been used as a lotion by Dr. Routh and 
others. 

Bromine in a free state being never used [to any extent] 
in medicine, we shall consider its properties under Bromide 
of Potassium. 

[Bromine is a valuable caustic, and is sometimes used 



BUCHU — CADMIUM. 135 

in gynaecology as an application to the uterus. It is said 
that its mixture with glycerine is liable to explode. It is 
useful in hospital gangrene both as a caustic, and in dilute 
solution as an antiseptic wash. Used internally, it resem- 
bles iodine in its effects as an alterant.] 



BUCHU— BUCHU. 

[ The leaves of Barosma Crenata and other species of Barosma, U. S. 

Officinal Preparations, U. S. 

Extractum Buchu Fluidum. Dose, f^ss.-j. 
Infusum Buchu (fjj. to Oj.). Dose, f^j.-ij.] 

Physiological Action. Therapeutical. 

The physiological action Buchu has long been val- 

of buchu is principally if not ued by surgeons as a useful 

entirely expended on the remedy in chronic catarrh of 

mucous membrane of the the bladder and the various 

genito-urinary organs. It is mucous discharges from the 

probable that the volatile oil genito-urinary organs de- 

which it contains, being rap- pending on a relaxed condi- 

idly taken into the blood and tion of the affected parts, 

as rapidly excreted by the [It is largely employed in 

kidneys, acts locally through the treatment of subacute 

the urine on the lining mem- or chronic gonorrhoea, re- 

brane of the bladder and sembling turpentine in its 

urethra. [It is also, to some effects, although far less stim- 

extent, diaphoretic] ulating. In incontinence or 

The urine is impregnated retention of urine, depend- 

with the peculiar odor of the ing upon want of tone in the 

drug, and is perhaps slightly bladder, it is a most useful 

increased in quantity. agent.] 



CADMIUM — CADMIUM. 

[Officinal Preparation. 

Cadmii Sulphas. Used externally. 

The sulphate of cadmium strongly resembles the cor- 
responding zinc salt in its properties, and is occasionally 
employed as an astringent collyrium (gr. i.-iv. to rose- 
water fsj.)- The iodide of cadmium is officinal in the 
British Pharmacopoeia, but] is only used in the form of 
unguentum cadmii iodidi [Br. gr. lxij. to £j.] in some 



I36 COFFEE — OIL OF CAJUPUT. 

cases of skin disease [making an admirable substitute for 
the iodide of lead]. 



CAFFEA— COFFEE. 

[ The seed of Caffea Arabic a, U. S.~\ 

Tea, coffee, guarana, and coca, substances containing the 
same alkaloid, caffeine, have much the same effect. 

CAFFEINE 

is a very active substance, causing at first increase, but 
later diminution, of the reflex functions of the cord, with 
nervous convulsions and muscular rigidity, the motor 
nerves not being affected. The heart's action is first ac- 
celerated, but afterwards retarded. The excretion of urea 
is lessened. The frequent and prolonged use of tea and 
coffee causes, in some persons, a variety of nervous sensa- 
tions, sleeplessness, numbness, and tingling of the extrem- 
ities, with irritability of the heart ; and there is no doubt 
that much loss of appetite and flatulent dyspepsia originate 
in the habit of drinking tea shortly before or after meals. 
The invigorating and restorative effects of tea and coffee 
are well known, and valued by persons undergoing much 
bodily fatigue. The therapeutic indications for tea and 
coffee are almost restricted to the administration of the 
latter substance in cases of opium-poisoning. 

Guarana in 20-grain doses has been found a useful 
remedy for migraine or sick headache, and the chewed 
leaves of the coca plant have been highly recommended 
by Sir R. Christison and others as a nervine and muscular 
stimulant. Although the respected Baronet found great 
benefit from this plant during severe exertion, Weston, 
the well-known pedestrian, gives his opinion as tending 
quite to the opposite conclusion. 



[OLEUM CAJUPUTI— OIL OF CAJUPUT. 

The volatile oil obtained from the leaves of Melaleuca Cajuputi 
{Roxburgh, Trans. Lond. Medico- Botan. Socy.), U. S. 

Cajuput oil is highly-prized in the East Indies as a stim- 
ulant carminative. The ordinary dose is gtt. ij.-v. , but 
it has been given with great success in the collapse of 
cholera, in doses of gtt. xv. to f 5j- It is also used as a 
rubefacient counter-irritant, diluted with olive oil. Like 



CALCIUM. I37 

other oils of this class, it relieves toothache when intro- 
duced into a carious tooth.] 



CALCIUM— CALCIUM. 

[Calcii Chloridum — Chloride of calcium prepared by 
fusion, U. S. 

Calcii Hypophosphis — Hypophosphiteof lime. Dose, 
gr. x.-xxx. 

Calx — Lime recently prepared by calcination, U. S. 

Calx Chlorinata — A compound resulting from the ac- 
tion of chlorine on the hydrate of calcium and containing 
at least 25 per cent, of chlorine, U. S. 

Officinal Preparations, U. S. 
Calcis Hydras. Used in pharmacy. 
Calcii Carbonas Praecipitata. Dose, gr. xx.-3j. 
Calcii Phosphas Praecipitata. Dose, gr. x-xxx. 
Creta Praeparata. Dose, gr. x.-xv. 
Hydrargyrum cum Creta (mercury 3 pts., chalk 
5 pts.). Dose, gr. v.-xxx. 
Trochisci Cretae. 
Mistura Cretae. Dose, fgss. 
Testa Praeparata. Dose, gr. x.-xv. 
Liquor Calcii Chloridi. Dose, fjss.-j. 
Liquor Calcis (lime-water). Dose, f 3j.-iv. 
Linimentum Calcis (lime-water f^viij., linseed oil 

fSvij.). 

Potassa cum Calce. Used as a caustic. 

Also used in the preparation of ^Ether Fortior, Ammo- 
nii Valerianas, Aqua Ammonise, Liquor Potassae, Liquor 
Sodse, Liquor Sodas Chlorinatse, Quinise Sulphas, Santoni- 
num, Spiritus Ammonise, Strychnia, and Sulphur Praecipi- 
tatum.] 

Local Action. 

Physiological. Therapeutical. 

Some of the preparations Lime is used as a soothing 

of lime, used externally, are application to burns, as in 

sedative or soothing; others the linimentum calcis; and 

are astringent. lime-water makes a good 

injection for lencorrhoea, or 
enema for the destruction of 
thread-worms. 
12* 



l$8 COLUMBO. 

Internal Uses. 

Lime, taken internally, It is therefore used with 
neutralises acid secretions, benefit in some forms of 
and has astringent proper- dyspepsia and in diarrhoea, 
ties. liquor calcis being the most 

generally employed prepa- 
ration. Lime-water is also 
of great service in prevent- 
ing the curdling which often 
causes milk to disagree with 
patients of weak digestion. 
Chalk is more astringent than lime, and is an excellent 
remedy, either alone or in combination with opium, for 
diarrhoea. 

Chloride of calcium has been highly praised in 20-grain 
doses as a remedy for various forms of scrofula. [The dose 
of chloride of lime (calx chlorinata) is gr. j.-v., but it is 
rarely prescribed, being principally used as a disinfectant.] 
Phosphate of lime has been highly praised by Ringer in 
doses of from 1 to 2 grs. in rickets, where it acts by im- 
proving the general nutrition of the system, and supplying 
structural elements in which the growing bones of badly 
nourished children are often deficient. [Thehypophosphite 
of lime has been highly recommended in consumption.] 



CALUMBA— COLUMBO. 

[The root of fateorrhiza palmata (lifters'), Cocctdus palmatus (De 
Candolle); and jateorrhiza Calumba {Alters), Cocctdus palmatus 
{Wallich Catal. noti D. C), U. S. 

Officinal Preparations, U. S. 

Extractum Calumbae Fluidum. Dose, nrxv.-xxx. 
Infusum Calumbae (root foss. to Oj.). Dose, f^j.-ij. 
Tinctura Calumbae (root gij. to Oj.). Dose, f5j.-ij.] 

Local Action. 
Calumba has no local action. 

Constitutional Action. 

Physiological. Therapeutical. 

0?i the Digestive Fitnc- Calumba is a good tonic 

tions. — Like all bitter tonics, in deficient appetite from in- 

calumba stimulates the appe- digestion or simple want of 



CAMPHOR. 139 

tite, and increases slightly tone, in various dyspeptic 

the secretion of saliva and conditions, and in most en- 

the gastric juice. It is lighter feebled states of the consti- 

and more agreeable than tution, from whatever cause 

some others of the class, and they may arise. [As it does 

has been believed to have not contain tannic acid, it 

sedative properties, in virtue maybe given in combination 

of which it may be bene- with iron.] 
ficially given in sickness and 
vomiting ; but of this we 
have been unable to obtain 
reliable evidence. 

Mode of Administration. 

Calumba is usually given in combination either with iron, 
with alkalies, or with other tonics. Thus: — 
1&. [Ferri et potassii tartratis] gjss ; 
Potassii bicarbonatis 5'j- j 

Syrupi hemidesmi [Br.] f^j. ; 

Infusi calumbae f" ^ v i j . 

Misce, fiat mistura. Capiat unciam unam bis in die. 

R. Pulveris calumbae gr. x. ; 

Sodii bicarb. gr. xx. ; 

Pulv. rhei gr. v. ; 

Pulv. zingiberis gr. x. 

M. Fiat pulvis bis in die sumendus ante cibum. 

A useful powder in some forms of dyspepsia. 



CAMPHORA— CAMPHOR. 

\^A peculiar, concrete substance, derived from Camphora officinarum, 
and purified by sublimation, U. S. 

Oleum Camphorse (Oil of Camphor). Dose, gtt. ij.-iij. 
Officinal Preparations, U. S. 

Aqua Camphorae (3j. to Oj.). Dose, f^ss-ij. 

Linimentum Camphorse (camphor 1 pt., olive oil 6 
pts.). 

Linimentum Saponis. 

Mistura Chloroformi (chloroform fjfss., camphor 3j- 
in f^vj.). 

Spiritus Camphorae (^ij. to Oj.). Dose, f3ss.-j. 

Tinctura Opii Camphorata (Paregoric). Dose, f^ss. 

Ceratum Plumbi Subacetatis (Goulard's Cerate). 



140 



CAMPHOR. 



Antidotes. 
Opium and stimulants.] 

Local Effects. 
Physiological. Th erapeutical. 

Camphor has some rube- Camphor forms an ingre- 
facient properties, redden- dient of most of the lini- 
ing and irritating the skin. ments in common use. 

Internal Action. 



1. Brain and Nervoits 
System. — Camphor in large 
doses causes a good deal of 
giddiness and confusion of 
ideas, even amounting in 
some cases to delirium. 

Muscular weakness is at 
first observed, but this rap- 
idly gives way to violent epi- 
leptiform convulsions and 
almost maniacal excitement. 
In frogs, well-marked lower- 
ing of the reflex irritability 
of the spinal cord has been 
observed. 



2. Circulation. — In small 
doses camphor seems to 
stimulate the heart's action, 
but after the administration 
of larger quantities great 
cardiac prostration has been 
observed by Dr. Geo. John- 
son and others. 



1. Camphor is not used 
[in large doses] on account 
of its action on the nervous 
system, and the results of the 
few experimenters who have 
been bold enough to try the 
effects of large doses on 
themselves have not been of 
a very encouraging nature. 
[It is moderately stimulating 
and diaphoretic, and pos- 
sesses undoubted anodyne 
and narcotic influence. In 
the spasmodic and nervous 
complaints of women cam- 
phor is extensively em- 
ployed.] 

2. Camphor has been 
found of service in the early 
stages of coryza, but must be 
here used with caution, as 
the homoeopathic tincture, 
which is generally pre- 
scribed [outside of the reg- 
ular profession], is now 
known to be a very strong 
preparation, and Dr. Geo. 
Johnson and others have 
described cases in which ex- 
cessive weakness and faint- 
ness, with great cardiac and 
muscular prostration, fol- 
lowed doses of from 15 to 



CANELLA — AMERICAN HEMP. 141 

20 minims [and several fatal 
cases of poisoning by it have 
been reported]. 

3. Respiration and Tem- 
perature. — No influence on 
the respiration is noted, but 
there is a marked lowering 
of temperature. 

4. Digestive and Secreting 4. Camphor is said to be 
Organs. — In large doses, a good remedy in summer 
some irritation of the gastro- diarrhoea. 

intestinal mucous membrane 
has been observed, with dia- 
phoresis, and the sexual ap- 
petite seems to be dimin- It is a popular antidote to 
ished. chordee. 



[CANELLA— CANELLA. 

The bark of Canella alba, U. S. 

Officinal Preparations, U. S. 

Pulvis Aloes et Canellse. Dose, gr. x.-xx. 
Vinum Rhei (rhubarb .^ij., canella 5j- to Oj.). Dose, 
f5j.-iv. 

Uses. 

Canella is an aromatic tonic, but is rarely prescribed 
alone. It contains no tannin, and may be given with a 
chalybeate. The powder of aloes and canella is a pop- 
ular remedy for amenorrhea under the title of Hiera Picra.] 



[CANNA— CANNA. 

The fecula fro7n the rhizome of an undetermined species of 
Canna, U. S. 

Canna-starch may be used like arrowroot as a bland 
nourishment for invalids.] 

[CANNABIS AMERICANA— AMERICAN HEMP. 

The flowering tops of Cannabis Sativa, cultivated in 
North America, U. S. 

Officinal Preparation, U. S. 
Extractum Cannabis Americanae. Dose, gr. j£ to 



142 



INDIAN HEMP. 



CANNABIS INDICA— INDIAN HEMP. 

[ The flowering tops of the female plant of Cannabis Sativa, 
variety Indica, CI. S. 

Officinal Preparations, U. S. 

Extractum Cannabis Indicse. Dose, gr. y 2 . 
Tinctura Cannabis (gr. iij. ad f 3 j . ) . Dose, gtt. x.-xx.] 

Local Action. 
Indian hemp is never used locally. 

Internal Actions. 



Physiological. 

1 . On Brain and Nervous 
System. — Indian hemp, like 
opium, possesses a double 
exciting and sedative action, 
the brain being stimulated 
into pleasant exhilaration 
before sleep sets in. This 
preliminary effect, however, 
is more powerful and lasting 
than in the case of opium, 
and the subsequent condi- 
tion of slumber is usually 
disturbed by dreams and 
spectral illusions. Various 
authors have given graphic 
descriptions of the intellect- 
ual disturbance produced 
by this drug, dwelling more 
especially on a peculiar feel- 
ing of double consciousness, 
leading on, in some cases, 
to partial catalepsy. 

We also find indications 
of some special affection of 
the sensory nerves, a marked 
degree of numbness and 
tingling, ushering in cutane- 
ous anaesthesia and diminu- 
tion of the muscular sense. 



Therapeutical. 
1. Indian hemp may be 
used as a narcotic when 
other remedies fail ; but its 
action is so uncertain and 
irregular, and the difficulty 
of procuring reliable prepa- 
rations so great, that our 
present knowledge does not 
enable us to lay down any 
practical rules for its employ- 
ment. Dr. Clouston, how- 
ever, has obtained valuable 
assistance in acute mania by 
prescribing the tincture in 
combination with bromide 
of potassium. Although 
later experience has not 
confirmed the pretentions of 
those who formerly vaunted 
Indian hemp as a cure for 
hydrophobia, chorea, tetanus, 
and allied nervous ailments, 
we may sometimes produce 
good results in neuralgia and 
migraine by its cautious use. 



CANTHARIDES. 143 

2. Circulation. — Some 
increased rapidity of pulse 
has been observed during 
the action of Indian hemp ; 
but it is probable that this 
is only due to the condition 
of nervous excitement which 
we have just described. 

3. Digestive System. — 
No special effect seems to 
be produced on the stomach 
or intestinal canal, and the 
absence of constipation fol- 
lowing its use gives Indian 
hemp one advantage over 
opium. 

Dose and Mode of Administration. 

R. Tincturae cannabis In dicae f3J-> 
Mucilaginis acaciae f §j. ; 

Syrupi zingiberis f ^ss. ; 

Aquas menthas piperitae ad f §vj. 

Misce, fiat mistura. Capiat unciam unara quarta quiique 
hora. 

In neuralgia, &c. 



CANTHARIS— CANTHARIDES. 

\Cantharis vesicatoria, Lytta vesicatoria (Fabrichis), U. S. 

Officinal Preparations, U. S. 

Tinctura Cantharidis. Dose, n^iij.-v. 
Ceratum Cantharidis. (For spreading blisters.) 
Ceratum Extracti Cantharidis. 
Charta Cantharidis. (Blistering papers.) 1 
Collodium cum Cantharide. 
Linimentum Cantharidis. 
Emplastrum Picis cum Cantharide. 
Unguentum Cantharidis (5ij. in gj.). 

Antidote. 
There is no antidote for cantharides.] 

1 [Charta Cantharidis and Charta Sinapis form the class of Chartae, 
U. S. P.] 



144 



CANTHARIDES. 



External Actions. 



Physiological. 

The first effect of the 
application of cantharides 
to the skin is tingling and 
smarting, speedily followed 
by vivid redness and severe 
burning pain. To this suc- 
ceeds the formation of large 
blebs containing a watery 
fluid rich in albumen and 
fibrine ; and if the blister be 
allowed to remain for any 
lengthened period in contact 
with the skin, ulceration and 
sloughing may supervene. 
It has been found that the 
moderate counter-irritant 
action of cantharides causes 
the copious exudation of 
white blood-corpuscles into 
the subcutaneous areolar 
tissue, with engorgement 
of the more superficial 
structures underlying the 
skin, whilst the deeper 
strata look pale, anaemic, 
and flabby ; the lungs even 
being affected in this way. 
It has also been shown that 
the irritant action of cantha- 
rides may penetrate through 
the skin, and cause redness 
and inflammation of the 
pleura and peritoneum. 
The first constitutional effect 
of a blister is a slight eleva- 
tion and subsequent depres- 
sion of the temperature, 
with weakening of the action 
of the heart. 

It not uncommonly hap- 



Th erapeutica I. 

Blisters are used to fulfil 
the following indications : — 

i. To relieve pain. There 
can be no doubt that blisters 
frequently check pain most 
effectually, as in subacute 
pleurisy, pleurodynia, gas- 
tralgia, sciatica, and neural- 
gia, it being important that 
in this last-named affection 
the counter-irritant should 
be placed as near as possible 
to the root of the affected 
nerve. 

2. To check inflammatory 
conditions. There is no 
doubt that some local in- 
flammations may be checked 
by blistering a neighboring 
vascular area. Thus, in 
iritis and some other inflam- 
matory affections of the eye, 
benefit may be procured in 
this way ; and in acute 
rheiwiatism blisters applied 
immediately above the in- 
flamed joints rapidly remove 
pain and swelling. 

On this principle, also, 
Mr. F. Jordan recommends 
his iodine treatment of 
localised surgical affections 
already referred to. 

In how far inflammations 
of internal organs may thus 
be treated with advantage is 
a somewhat open question ; 
for although the withdrawal 
of blood from the deeper 
structures might theoreti- 



CANTHARIDES 



145 



pens that cantharides may 
be absorbed through the 
skin, and cause kidney irri- 
tation. 



cally be considered benefi- 
cial, it is practically found 
that the pain and annoyance 
of blisters add to the feverish 
discomfort of the victims of 
acute disorders. 

3. To promote absorption. 
Blisters are supposed to aid 
the absorption of effused 
products, fluid or solid, and 
are therefore much used in 
thoracic dropsy ', either pleu- 
ral or pericardial, the latter 
stages of pneumonia, chronic 
joint- disease, &c. 

4. To stimulate and alter 
vascular or nervous func- 
tions, &c. Blisters may be 
employed to rouse patients 
from the stupor of typhus, or 
narcotic poisoning, or vari- 
ous brain affections, to check 
obstinate vomiting, and un- 
der various other conditions 
laid down in works on 
practical medicine. 



Internal Actions. 



Physiological. 
Cantharides is a gastro- 
intestinal irritant, and also a 
renal irritant and diuretic, 
causing an increased flow of 
urine, but frequently giving 
rise to a good deal of 
strangury, with painful, fre- 
quent, and difficult mictu- 
rition, and bloody urine. 
This irritation may spread 
by sympathy to other allied 
organs, and uterine excite- 
ment on the one side, or 
excess of venereal appetite 

1 3 



Th erapeutical. 

Cantharides is not much 
used internally, on account 
of its irritating properties. 
It is, however, occasionally 
prescribed in pyelitis and 
some chronic affections of 
the kidney, and in chronic 
diseases of the spine. 

Some authorities also have 
praised it highly in psoriasis. 
It has also been used for the 
purpose of procuring abor- 
tion, and it possesses em- 
menagogue properties. 



1 46 CAPSICUM. 

with chordee and seminal 
emissions on the other, may 
follow the administration of 
large doses. 1 

Cautions. Mode of Administration. 

We must use blisters with caution under the following 
circumstances: — 

In the aged, infirm, or very young, where troublesome 
ulceration is apt to ensue. 

In acute inflammatory conditions, and more especially 
those of the kidney. 

To cicatricial tissue, or to parts deprived of some of 
their vitality by the withdrawal of nervous influence, as in 
paraplegia. 

Blisters are usually kept on from ten to twenty hours, 
but we may well limit the period to six or eight hours, 
and develop the blebs by a subsequent poultice. When 
the desired effect has been produced, let out the watery 
fluid, and apply a thick layer of cotton-wool. 



CAPSICUM— CAPSICUM. 

\_Syn. Cayenne and African Pepper. 

The fruit of Capsicum annuum, Capsicum fastigiatum (Blum), 
and other species of Capsicum, U. S. 

Officinal Preparations, U. S. 

Infusum Capsici. Dose, f,?ss. 
Oleo-Resina Capsici. Dose, gtt. j. 
Tinctura Capsici. Dose, f3j--ij-] 

This is a topical stimulant to the mucous membranes, 
exciting the appetite in small doses, but in larger quanti- 
ties causing gastro-enteritis. In some forms of sore throat, 
as in the early stage of tonsillitis, or in simple relaxation 
of the mucous membrane, it forms a useful addition to 
a gargle [as infusum capsici]. 

Recently it has been highly praised by Dr. Lyons, of 

1 [The tincture of cantharides, U. S. P., is more than twice the 
strength of the English preparation.] 



CARBON. 147 

Dublin, in ten-minim doses of the tincture before meals, 
for the relief of the nausea, depression, and drink-craving 
of confirmed dipsomaniacs. 

]$. Tincturae capsici n\x. ; 

Tincturae nucis vomicae H|x. ; 

Acidi nitrici cliluti Tu. xx. ; 

Aquae ad f §j. 

Fiat haustus ter die sumendus. 

Useful in drink-craving. 



CARBO— CARBON. 

[Carbo Animalis — Charcoal prepared from bone, U. S. 

Used in preparing Cinchoniae Sulphas, Morphia, Quinise 
Sulphas, and Santoninum. 

Carbo Ligni — Charcoal prepared 'from wood, U. S. 

Used in preparing Acidum Sulphurosum and Potassii 
Iodidum. 

Officinal Preparation. 

Carbo Animalis Purificatus. 

Used in making Acidum Gallicum, Digitalinum, Strych- 
nia, and Veratria.] 

Local Actions. 

Physiological. Th erapeutical. 

Charcoal has no purely 1. In virtue of its absorbing 

local action on any tissue powers, charcoal is used in 

with which it is brought in many of those cases of dys- 

contact, and as it is quite pepsia where large quantities 

insoluble it can exert no of gas are formed by prema- 

general influence on the ture decomposition of the 

functions of the body. It is food, and where much pain, 

therefore simply a mechan- nausea, and want of appetite 

ical agent, and acts in virtue are experienced by the pa- 

of the following properties, tient. In consumption and 

1. It not only freely ab- many chronic stomach dis- 

sorbs gases within its pores, orders charcoal acts well by 

but oxidises and destroys relieving the falulence which 

those of an offensive and is often the chief discomfort 

injurious nature, as sulphu- of the sufferer. Charcoal is 

retted hydrogen ; and fur- also an excellent deodoriser 

ther, it also deodorises, by and antiseptic, and is used 

oxidation, and destroys or- for these purposes in the 



148 



CARBON. 



game impurities of all kinds, 
decolorising solutions which 
contain them. 



2. Animal charcoal pos- 
sesses the power of render- 
ing various vegetable poisons 
inert by placing them in a 
form of combination beyond 
the absorptive powers of the 
stomach. 



construction of filters, con- 
tact for four months being- 
sufficient to purify the foul- 
est and most deeply stained 
waters ; and if the organic 
matter present does not ex- 
ceed from i to 2 grains per 
gallon the charcoal will per- 
manently retain its cleansing 
properties. It may also be 
of great service in absorbing 
and destroying offensive ef- 
fluvia in the neighborhood 
of sewers or drains, and it 
used to be a fashionable ap- 
plication to unhealthy ul- 
cers j but cleaner and equally 
effectual antiseptics have 
now entirely displaced it 
from popular favor. 

It is also occasionally em- 
ployed in the formation of 
respirators and as an adjunct 
to tooth powders, and Dr. 
Thorowgood advises its pre- 
scription in teaspoonful 
doses in bleeding piles. 

2. If we are called very 
early to a case of poisoning 
by opium, aconite, strychnia, 
or other vegetable poison, 
we may hope to do some 
good by charcoal, provided 
that absorption of the poi- 
sonous agent has not yet 
taken place to any extent. 



Mode of Administration. 

As a medicinal agent vegetable charcoal alone is used, 
and may be given in doses of from a tea- to a table-spoon- 
ful, great care being taken to insure perfect freshness, as 
its absorptive powers are seriously impaired by keeping. 
It may be combined effectively with bismuth, or given in 



CARDAMOM — CARAWAY CLOVES. 149 

sandwich form between bread and butter, or moistened 
with spirit in a wineglass before suspension by water ; but 
in any case its unsightly appearance, gritty consistence, 
and insolubility interfere with its prescription in elegant 
form, and we may advise our patients with advantage to 
make use of Bragg's biscuits or Belloc's lozenges. 

As an antidote, animal charcoal must be given in con- 
siderable doses, as it is calculated that half an ounce is 
required to neutralise one grain of vegetable alkaloid. 
As an antiseptic it may be placed in shallow pans close to 
the outlet of drain or sewer ventilating shaft. 



CARDAMOMUM— CARDAMOM. 

\_The fruit of ' Elettaria Cardamomum, U. S. 

Officinal Preparations, U. S. 

Extractum Colocynthidis Compositum. Dose, gr. 
v.-xxx. 

Pulvis Aromaticus. Dose, gr. x.-xxx. 
Tinctura Cardamomi. Dose, f 5j.-ij. 
Tinctura Cardamomi Composita. Dose, f 3j.-iv. 
Tinctura Gentianse Composita. Dose, f 3j.-ij. 
Tinctura Rhei. Dose, f 3j.-iv. 
Vinum Aloes. Dose, f 3j--f 3j-] 

This is an agreeable stimulant and flavoring adjunct. 



[CARUM— CARAWAY. 

The fruit of Carum Carui, U. S. 

Officinal Preparations, U. S. 

Oleum Cari. Dose, gtt. j.-x. 

Tinctura Cardamomi Composita. Dose, f3j.-f Iss. 

Caraway is an agreeable aromatic, used as a stomachic, 
or to prevent the griping of other medicines. The oil is 
most frequently employed, but an infusion may be made 
containing 3 i j - to Oj.] 



CARYOPHYLLUS— CLOVES. 

[ The unexpanded flowers of Caryophyllus Aromaticus, U. S. 

13* 



150 CASCARILLA — CASTOR. 

Officinal Preparations, U. S. 

Infusum Caryophylli (3ij. to Oj.). Dose, fgij. 
Oleum Caryophilli. Dose, gtt. ij.-vj. 
Spiritus Lavandulae Compositus. Dose, f5j.-ij. 
Syrupus Rhei Aromaticus. For infants, f5j. 
Vinum Opii. Dose, gtt. xv.-xxx. 

Cloves are a stimulating stomachic, and may be given 
in substance in doses of gr. v.-x.] Cloves, pimento, and 
oil of cajuput are carminative and perhaps antispasmodic, 
and may be useful in flatulent colic, hysteria, &c, more 
especially as adjuncts to other remedies. 



CASCARILLA— CASCARILLA. 

\_The bark of Croton E Inter in, U. S. 

Officinal Preparation, U. S. 
Infusum Cascarillae. Dose, f.lij.] 
Cascarilla is a light and agreeable tonic. 



[CASSIA FISTULA— PURGING CASSIA. 

The fruit of Cassia Fistula, U. S. 

Cassia pulp is laxative in doses of one or two drachms, 
but is rarely used except in the officinal combination, 
Confectio Sennas, which is a favorite remedy against con- 
stipation in pregnancy. Dose, 5j--ij-] 



CASSIA MARILANDICA— AMERICAN SENNA. 

[ The leaflets of Cassia Marilandica, U. S. 

This is a competent substitute for the imported senna as 
a cathartic, but must be administered in rather larger 
doses. It is much used in the form of infusion, combined 
with fennel or some other aromatic to prevent griping.] 

CASTOREUM— CASTOR. 

\_A peculiar concrete substance obtained fron Castor Fiber, U. S. 

Officinal Preparation, U. S. 
Tinctura Castorei. Dose, fjss.-ij.] 



CATNEP — CATECHU. 151 

Castoretim and musk possess much the same properties, 
the only difference being in the greater strength of the 
latter. They are stimulant and antispasmodic; but cas- 
toreum is rarely if ever used, and even musk, which was 
formerly much valued in France, and by Graves of Dub- 
lin, in typhus, pneumonia, and other diseases tending to 
assume an adynamic type, has now also fallen into com- 
parative disuse. 



[CATARLA— CATNEP. 

The leaves and tops of Nepeta Cataria, U. S. 

Infusion of catnep (catnep tea) is a favorite remedy for 
flatulent colic in infants, but is rarely used for any other 
purpose in regular practice, although a hot infusion is a 
domestic remedy for amenorrhea and hysteriaJ\ 



CATECHU— CATECHU. 

An extract prepared principally from the wood of Acacia Catechtt, U. S. 

Officinal Preparations, U. S. 

Infusum Catechu Compositum. Dose, f^j.-iij. 
Tinctura Catechu. Dose, f3j.-iij. 

Internal Effects. 
Physiological. Therapeutical. 

Catechu has powerful as- It is a much-used drug in 
tringent properties. the relaxed conditions of 

various mucous membranes, 
but more especially in diar- 
rhea, and it constitutes an 
essential ingredient in the 
mixtures generally prescrib- 
ed for the relief of that con- 
dition. 

R. Tincturse catechu f5 v J-5 

Pulveris cretse aromatici [Br.] £ij.; 

Tincturae opii f.^ij-; 

Mucilaginis fgj.; 

Aquae cinnamomi ad flvj. 
Misce, fiat mistura, cujus sumat semunciam post singulas 
dejectiones liquidas. 



152 WAX — CERIUM — SPERMACETI. 

CERUM— WAX. 

[Cera Alba. Yellow wax bleached, U. S. 
Cera Flava. A peculiar concrete substance prepared 
by Apis mellifica, U. S. 

Wax is a good excipient, and is the basis of the cerates. 
It also enters into pills, ointments, plasters, and supposito- 
ries. It is an ancient remedy for dysentery. 

Cerata. 

List of Cerates officinal in the U. S. Pharmacopoeia: — 

Ceratum (formerly Ceratum adi- Ceratum Resinoe. 

pis). " Resinas Compositum. 

Ceratum Cantharidis. " Sabinse. 

" Cetacei. " Saponis. 

" Extracti Cantharidis. " Zinci Carbonatis.] 

" Plumbi Subacetatis. 



CERIUM— CERIUM. 

[Cerii Oxalas — Oxalate of Cerium.] 

The oxalate of cerium, in doses of from gr. j. to gr. ij., 
is a popular remedy in the vomiting of 'pregnancy , its mode 
of action being quite unexplained, and its success being, 
according to my own experience, greatly exaggerated. 

It is generally prescribed in the form of pill. 

]£. Cerii oxalatis gr. xxiv.; 

Extracti gentianse gr. xxxvj. 
Misce, fiant pilutae duodecim, quarum capiat unam bis 
in die. 

[Disappointment from the use of this drug may be ex- 
plained by the fact that the commercial oxalate of cerium 
often contains salts of lanthanum, didymium, and other 
impurities. The chemically pure oxalate of cerium is 
probably one of the most efficient remedies against the 
vomiting of pregnancy that we possess; given in powder, 
in pill, or suspended in mucilage.] 

CETACEUM— SPERMACETI. 

[ A peculiar concrete substance obtained from Physeter macroccphalus, 

U. S. 

Officinal Preparations, U. S. 
Ceratum Cetacei, Charta Cantharidis, Unguentum Aquse 
Rosae.] 



ICELAND MOSS — PIPSISSEWA. 153 

Requires no special notice. [Its internal use has been 
generally abandoned. The ointment, a perfectly bland 
preparation, may be used as a dressing to blistered surfaces. 
The unguentum aquae rosse, or cold cream as it is called, 
is much used for chapped hands and lips, and excoriated 
surfaces.] 



CETRARIA— ICELAND MOSS. 

\Cetraria Islandica (Acharius, Lichen Univ.), U. S. 

Officinal Preparation, U. S. 

Decoctum Cetrarise. Dose, f|ss.-iv.] 

This plant is supposed to have nutritious properties [and 
formerly enjoyed a great reputation as a demulcent and 
tonic in pulmonary affections']. 



[CHENOPODIUM— WORMSEED. 

The fruit of Chenopodium Anthelminticiun, U. S. 
Dose, in substance, gr. xx.-xl. 

Officinal Preparation. 
Oleum Chenopodii. Dose for a child, gtt. v.-x. 

Internal Effects. 

A popular remedy against lumbricoid worms. It may 
be given night and morning for two or three days, then 
to be followed by a brisk cathartic] 



[CHIMAPHILA— PIPSISSEWA. 

The leaves of Chimaphila umbellata (Picrsh, Flor. Amer. Sept.'), U. S. 

Officinal Preparations, U. S. 

Decoctum Chimaphilse. Dose, f Jij.-iv. 
Extractum Chimaphilse Fluidum. Dose, ttlxx.-xI. 

Wintergreen is an Indian remedy for scrofula, rheuma- 
tism, and nefhritic affections, and it enjoys some reputation 
as an alterative in regular practice, and has been recom- 
mended as a diuretic in dropsy. It is also tonic and 
astringent.] 



!54 



CHIRETTA CHLORAL 



[CHIRETTA— CHIRETTA. 

The herb and root of Agathotes Chirayta, U. S. 

Not much used in this country. See note under Gentian . ] 



CHLORAL— CHLORAL. 

\Syn. Hydrate of Chloral, U. S. 

Treatment of Poisoning. 

There is no direct antidote for chloral, but the treatment 
must be conducted on general principles for narcotic poi- 
soning, by evacuants, counter-irritants, stimulants, and 
maintaining bodily heat.] 



Local Actions. 



Physiological. 

When applied externally, 
chloral has been by some 
authorities supposed to have 
sedative properties, and it is 
also an undoubted antiseptic. 



Tli erapeutical. 



It has been recommended 
as an external application in 
neuralgia, ' rheumatism, and 
other painful affections. 

Used as a dressing to 
ulcerated surfaces, it seems 
to act well by removing the 
fcetor of discharges and 
lessening pain ; and it has 
been successfully employed, 
in solution, for the preserva- 
tion of anatomical prepara- 
tions. 



Constitutional Actions. 



I . Nervous System . — i . 
Brain. — Chloral [acts as a 
sedative to the nervous cen- 
tres and secondarily to the 
heart. In small doses it pro- 
bably] produces an anaemic 
condition of the brain, and 
thus causes sleep by imitat- 
ing the natural anatomical 



i. Chloral is an excellent 
hypnotic, causing sound and 
refreshing sleep, without the 
digestive disturbance which 
usually follows the use of 
opium. It may be given in 
simple insomnia from mental 
worry, overwork, or other 
causes, and it is a remedy of 



CHLORAL. 



155 



arrangement of that process. 
The resulting slumber begins 
very quickly after the dose 
is swallowed, it is usually 
sound and dreamless, and 
the patient wakes in seven 
or eight hours, well re- 
freshed, and without any 
marked feelings of malaise 
or digestive disturbance. 
Exceptions to this, however, 
have been observed, and in 
these chloral has caused 
preliminary excitement ; but 
it is more than probable that 
an explanation may be 
found in the use of the 
impure specimens of the 
drug too often retailed. 
Liebreich believes that chlo- 
ral exerts its hypnotic influ- 
ence by undergoing trans- 
formation in the blood into 
chloroform and formic acid ; 
but this is improbable for 
the following reasons : — 

(1) The alkali of the 
blood is too feeble to liber- 
ate the chloroform, and the 
albumen is considered an- 
tagonistic to such a process. 

(2) No smell of chloro- 
form can be observed in the 
breath, and no anaesthetic 
effect is produced on the 
sleeper by moderate doses. 

2. Spinal Cord. — The 
reflex irritability of the 
spinal cord is very decidedly 
lessened, and the respiratory 
centre becomes weakened, 
and eventually paralysed. 



great value in all diseases in 
which dangerous depression 
is apt to follow the continu- 
ous want of sleep. Thus, 
in typhus, in delirium tre- 
mens, where it must be 
pushed boldly in conjunction 
with an absolute suspension 
of all alcohol, in phthisis, 
acute mania, &c, we may 
prescribe it with much con- 
fidence of success. It has 
also been recommended in 
France as an anaesthetic by 
subcutaneous [intravenous] 
injection ; from 2 to 4 
drachms, thus made to enter 
the veins, being there sup- 
posed to yield chloroform, 
which then exerts its usual 
influence. There is no 
reason, however, to believe 
that anaesthesia thus pro- 
duced is in any degree safer 
than the old mode of inha- 
lation ; and as the patient 
is thus exposed to the addi- 
tional risks of thrombosis, 
inflammation of the veins, 
and the entrance of air, one 
cannot wonder that this 
process has found no favor 
in this country. 



2. Chloral is of service in 
some spasmodic diseases, as 
chorea, who oping- coitgh, asth- 
ma, ijicontinence of uri?ie, 
labor afterpains , &c. It is 
also undoubtedly useful in 
[trismus nascenlium, puer- 



3 5 6 



CHLORAL. 



3. Sympathetic and general 
Nervous System. — The vaso- 
motor system is enfeebled, 
but no special effect seems 
to be produced on other 
nervous structures, unless 
we believe a part of the loss 
of muscular power, some- 
times observed in those who 
have taken chloral for some 
time, to be due to an action 
on the motor nerves. 

1 1 . Circulatory System . — 
Chloral has a powerful 
action on the heart, lowering 
and weakening its action by 
paralysing its contained 
sympathetic ganglia. That 
this effect is not produced 
through the medium of the 
vagi is shown by the fact 
that it comes on even after 
these nerves are cut, and 
their terminal cardiac fila- 
ments paralysed by atropine. 
Along with this slowing of 
the pulse we get lessened 
arterial tension from dilata- 
tion of the superficial 
vessels. [Professor Wood 1 
states that it would seem 
most probable that the 
chloral influences the heart 
through the centres at the 
base of the brain.] 



peral convulsions, and] cases 
of tetanus, several of which 
have recovered during its 
administration, and it may 
also be given as an antidote 
to strychnia. 

3. Chloral, having no 
influence over sensory 
nerves, has no power, per 
se, of allaying pain, and is 
therefore useless in that class 
of cases where opium is of 
such signal service. 



II. Chloral, weakening 
cardiac action, must not be 
given where we have any 
reason to suspect an en- 
feebled state of^he heart 
muscle. 



1 [Therapeutics and Materia Medica, 2d ed., Phila. 1877, p. 321.] 



CHLORAL, 



157 



III. Respiration and Tem- 
perature. — The breathing 
tends to become slower, 
and finally to cease, from 
paralysis of the respiratory 
centre ; but urgent dyspnoea 
has occasionally been ob- 
served, and this has been 
ascribed to dilatation of the 
pulmonary vessels, causing 
an increased afflux of blood 
to be directed suddenly to 
the lungs. 

The temperature falls, 
and this is no doubt due to 
surface evaporation pro- 
duced by the dilated cutane- 
ous vessels. 

IV. Secreting a?zd Diges- 
tive Systems. — No special 
influence is produced on any 
of these, but occasionally 
vomiting and purging have 
followed the use of chloral. 



III. This effect on the 
respiratory centre naturally 
suggests caution in pre- 
scribing chloral in cases of 
advanced bronchitis with 
rapidly accumulating mucus 
secretion and deficient oxy- 
genation of the blood. 



Absorption and Mode of Elimination. 

Chloral is rapidly absorbed by the blood, and given out 
probably by the urine. 



Poisonous Effects. 

Chloral may kill by car- 
diac syncope, and, as this 
effect has been known to 
follow a single dose of 30 
grains, considerable caution 
must be exercised in its use ; 
or again, death may ensue 
from paralysis of the respi- 
ratory centre, with coma and 
gradual suffocation ; and, 
finally, a series of cases has 
been recorded in which 
14 



Antidotes. 

Here our efforts must first 
be directed to obviating the 
tendency to death. We must 
endeavor to restore the 
heart's action by warmth 
and stimulants ; promote 
breathing by irritation of the 
surface, galvanism, and arti- 
ficial respiration; counteract 
the rapidly-lowering tempe- 
rature, on which so much 
danger depends, by warmth; 



158 CHLORAL. 

symptoms arose akin to and finally employ physio - 
blood poisoning, with pur- logical antidotes, such as 
puric and scorbutic erup- atropia and strychnia, 
tions, ulceration of gums, 
and great prostration, end- 
ing in death. 

Cautions, Mode of Administration, Dose, &c. 

[It is recommended that re-crystallized chloral should 
only be prescribed, as the commercial article is liable to 
be contaminated with impurities, and the results of decom- 
position.] 

The use of chloral requires caution, as many instances 
of death from its employment are on record, and other 
cases have been noted in which very serious symptoms 
followed doses varying from 30 to- 50 grains. We must 
also be mindful of other physiological peculiarities. Thus 
great muscular prostration, more especially affecting the 
legs, and causing staggering, not very unfrequently follows 
its continued use. 

Various skin eruptions, usually confined to the face, 
beginning as spots of roseola, coalescing to form patches 
of erythema, and the very peculiar deep flushing of the face 
following the use of stimulants and due no doubt to vaso- 
motor paralysis, have been carefully described by Dr. 
Crichton Browne and other observers. 

Considering the undoubted fact that not only dangerous 
symptoms, but even death, have followed a dose of 30 
grains [and even of 10 grains], we must begin, as a rule, 
with 20 grains [or a smaller quantity], to be repeated as 
occasion requires. We must remember, however, that the 
narcotic action of chloral is not invariably exhausted in 
the single sleep to which it originally gives rise, but may 
be held over until next night, so that our best practice will 
be to give a full dose only once in the forty-eight hours. 
The taste and smell of chloral being pungent and disagree- 
able, we must endeavor to render our prescription as 
palatable as we can. The syrup contains 10 grs. to the 
drachm. Or we may use the following formula: — 

I£. Chloral hydratis gr. xx. ; 

Syrupi aurantii f ^j ; 

Aq. menth. pip. ad f^ij. M. 
Fiat haustus bora somni sumendus. 



CRO TON-CHLORAL 



J 59 



[The addition of gr. v. of chloral to a small dose of 
morphia greatly adds to its hypnotic effect, and prevents 
unpleasant results that sometimes are produced by morphia 
alone. 

Note. — Chloral-Camphor. By rubbing together gum camphor 
and chloral, a fluid is produced resembling simple syrup. This has 
been recommended as a local anaesthetic in neuralgia, applied with a 
brush to the external skin. It is rubefacient, but not vesicating.] 



CROTON-CHLORAL. 

(Not Officinal.) 

\_A chlorated aldehyde of crotonic acid, made by the action of chlorine 

upon aldehyde.^ 

Local Action. 
None has been described. 

Constitutional Action. 



Physiological. 
I. Nervous System. — i. 
Brain. — Croton-chloral 
causes sleep in from fifteen 
to twenty minutes. 



Th erapeutical. 

I. Croton-chloral has been 
highly praised by its disco- 
verer, Liebreich, as a nar- 
cotic, being given by him 
in doses of from 15 to 30 
grains. There is little En- 
glish experience to quote on 
this heading, as the doses 
used here are far too small 
to produce sleep ; but as the 
drug has no depressing ac- 
tion on the heart like chlo- 
ral, there is no doubt that 
we may prescribe it with 
comparative freedom. [Sub- 
sequent experience contra- 
dicts this view, as dangerous 
and even fatal symptoms 
have been produced by or- 
dinary doses in cases of 
organic heart disease. It 
appears to resemble chloro- 
form in its uncertainty and 
danger.] 



i6o 



CHLORINE. 



2. Spinal Cord. — No ac- 
tion is produced on the 
spinal cord, nor consequent 
muscular relaxation. Some 
paralysing influence is event- 
ually exerted on the me- 
dulla. 

3. Sympathetic and other 
Nervous Systems. — No influ- 
ence seems to be exerted on 
the vaso-motor nerves, but 
on the fifth a well-marked 
sedative effect is noted, indi- 
cated by anaesthesia of the 
head and face, loss of irri- 
tability of the eyeball, and 
failure of the nerve-trunk 
itself to respond to galvanic 
stimulation. 



II. Circulation. — Croton- 
chloral has no tendency to 
weaken or lower the action 
of the heart [in health]. 

III. Respiration and Tern- 
perature. — Croton -chloral 
tends to lower the rate of 
breathing, and eventually 
kills by paralysing the respi- 
ratory centre. 



3. The anaesthetic influ- 
ence of croton-chloral would 
naturally suggest its use in 
facial neuralgia, and a good 
deal of success has been thus 
obtained in dealing with this 
troublesome affection, doses 
of from 2 to 6 grains having 
generally been prescribed. 
[Before administering this 
remedy the heart should al- 
ways be examined, as croton- 
chloral is contra-indicated 
by cardiac disorder.] 



III. [Croton-chloral close- 
ly resembles chloral hydrate 
in its action upon the system, 
except in possessing greater 
danger. For this cause its 
use has been afmost entirely 
discontinued in this coun- 
try.] 



CHLORINUM— CHLORINE. 

[Aqua Chlorini,U. S. Chlorine water. Dose,f£j.-iv.] 

The use of chlorine is almost entirely confined to its 
external application. 

Physiological A ction. TJi erapeutical A ction. 

1. Concentrated chlorine 1. It is never, however, 

gas directed upon the skin used as a counter-irritant. 



CHLORINE 



161 



causes redness and smarting, 
followed by a pustular erup- 
tion and even erysipelatous 
inflammation. 

2. It is an excellent dis- 
infectant, decomposing sul- 
phuretted hydrogen and am- 
monium sulphide at once 
and more effectually than 
any other gas, and also de- 
stroys organic matter in the 
air, as it bleaches organic 
pigments and destroys odors, 
either by abstracting hydro- 
gen or by oxidising (Parkes). 

3. The inhalation of chlo- 
rine gas is stimulating or 
irritating to the lungs. 



2. It is therefore exten- 
sively used as given off by 
chloride of lime to purify 
the air from offensive efflu- 
via, and to destroy infectious 
germs. In the form of lotion 
it is also used to cleanse foul 
or sloughing sores. 



3. It has therefore been 
used in some forms of chro- 
nic bronchitis and phthisis, 
but is not now much em- 
ployed. [It may be used in 
strychnia-poisoning, ] 



Internal Use. 

Chlorine used to be given internally in medicine in va- 
rious infectious fevers with a view to disinfection, but this 
has now become quite obsolete. 

Dose and Mode of Administration. 

As a disinfectant it may be obtained by acting on chloride 
of lime with water or dilute sulphuric acid, or by pouring 
four parts by weight of strong hydrochloric acid on one 
part of powdered binoxide of manganese, or mixing four 
parts of common salt and one of binoxide of manganese 
with two parts by weight of sulphuric acid and two of wa- 
ter, varying the quantities according to the size of the room. 

Vapor chlori is used for inhalation, and liquor chlori 
may be employed diluted as a lotion, or n|,x. to n^xxx. 
be given internally. 

Disadvantage. 

The great drawback of chlorine is the very irritating 
nature of its vapor, rendering it unsuitable for general use 
in rooms actually inhabited by the sick. 

14* 



1 62 MURIATIC ACID. 

ACIDUM MURIATICUM— MURIATIC ACID. 

\An aqueous solution of hydrochloric acid gas, of the specific gravity 

i, 1 60, U. S. 

Officinal Preparations, U. S. 

Acidum Muriaticum Dilutum. Dose, n^x.-xx. 

Also enters into the preparation of Acidum Hydrocyan- 
icum Dilutum, Antimonii Oxidum, Calcii Phosphas Praa- 
cipitata, Carbo Animalis Purificatus, Quinise Sulphas, 
Strychnia, Sulphur Prsecipitatum, and Acidum Nitromuri- 
aticum, Aqua Chlorini, Barii Chloridum, Ferri Chloridum, 
Liquor Arsenici Chloridi, Liquor Calcii Chloridi, Liquor 
Ferri Chloridi, Liquor Zinci Chloridi, Morphias Murias, 
and Resina Podophylli. 

Antidotes. 

The same as the other mineral acids, the alkalies and 
their carbonates: magnesia, soap, and bland drinks may 
be freely given. Muriatic acid stains the mouth and lips 
black, when taken undiluted.] 

External Use. 

Hydrochloric acid is a good form of application to diph- 
theriavfYizn. it is used combined with equal parts of honey. 

Internal Use. 

Of all the acids used in medicine, this has undoubtedly 
the most beneficial action in dyspepsia, on account prob- 
ably of its forming one of the normal constituents of the 
gastric juice. In cases where we suspect the formation of 
an excessive quantity of this fluid, we may, on the princi- 
ples already enunciated, limit its secretion by prescribing 
the acid immediately before meals. When the epigastric 
pain comes on immediately after eating, the condition is 
no doubt due to an irritable or perhaps ulcerated con- 
dition of the stomach itself, and we may best hope for 
success by carefully regulated diet and the use of bismuth, 
soda, or hydrocyanic acid. But when the pain does not 
set in with severity until from an hour to a couple of hours 
after food has been swallowed, the explanation probably 
is that an abnormal excess of gastric juice has been secreted, 
and a recurrence of this will best be checked by giving a 
little of the acid before meals. 



CHLOROFORM. 163 

Hydrochloric acid has also been much recommended by 
Dr. Chambers and others in typhoid fever, and it will gen- 
erally be found that 20-minim doses of the dilute acid are 
very grateful to the patient, as quenching the thirst and 
moistening the tongue. Dr. George Johnson has recent- 
ly taken exception to this, on the ground that the acid 
irritates the ulcerated surfaces of Peyer's patches ; but not 
only does mere empirical experience demonstrate the 
harmlessness as well as the convenience of this mode 
of treatment, but it is quite evident that the contact of at 
least three alkaline secretions must considerably modify 
the reaction of the acid before it reaches the seat of disease, 
and prevent it from retaining much irritating power, and 
I should therefore look upon these views of Dr. Johnson 
as having little practical value. 

Dose. 

In dyspepsia rrrxx. ad xxx. In typhoid fever nrxx. 
every two hours. 

$.. Acidi hydrochlorici dil. Til_xx. ; 
Sp. chloroformi rr^xv. ; 

Gentianse infusi f §j. M. 

S. Ter in die. 
In dyspepsia. 



CHLOROFORMUM— CHLOROFORM. 

[Chloroformum Venale, U. S. Commercial Chloro- 
form. 

Chloroformum Purificatum, U. S. Purified Chloro- 
form. 

Officinal Preparations, U. S. 

Mistura Chloroformi (f^ss. in fjvi.). Dose, f^ss. 
Spiritus Chloroformi (f.lj. to Alcohol f^vj., U. S.). 1 
Dose, f5ss.-j. 

Linimentum Chloroformi (f chloroform, | olive oil). 
Liquor Gutta-Perchae. And in preparing Atropia. t 

Poisoning. 

In the treatment of chloroform-narcosis when there is 
failure of the circulation, vigorous and prompt measures 

1 [Spiritus Chloroformi, Br., contains one part in twenty.] 



164 



CHLOROFORM. 



are called for. The surface of the chest should be smartly 
slapped with the fringe of a towel dipped in ice-water, a 
piece of ice may be introduced into the rectum, the head 
must be lowered and the legs elevated, and ammonia held 
to the nose; an assistant meanwhile practising artificial 
respiration. This treatment Prof. Gross has found to be 
invariably effective, and he has not lost a patient out of 
more than 5,000 cases of chloroform-anaesthesia.] 



Local Action. 



Physiological. 

Chloroform, when allowed 
to remain for some time in 
contact with the skin, acts as 
an irritant, causing redness 
and smarting, followed by 
vesication. 

It has also, however, some 
sedative properties. ' 

Chloroform is an excel- 
lent solvent of caoutchouc, 
gutta percha, and many fats 
and resins, and it also greatly 
assists the cutaneous absorp- 
tion of most of the alkaloids. 



Th erapeutical. 



The locally sedative ac- 
tion of chloroform has led to 
its extensive use as an appli- 
cation for the relief of rheu- 
matic or neuralgic pains, the 
liniment being a convenient 
form. 

It is also a useful remedy 
for allaying the itching of 
some chronic forms of skin 
disease. 



Constitutional Action. 



Chloroform, when taken 
internally, may act as a stim- 
ulant, sedative, and anti- 
spasmodic. 



It is a useful remedy in 
hysteria, asthma, and nervous 
palpitation, for the arrest of 
sea-sickness and other forms 
of vomiting, and for the 
soothing and quieting of 
some forms of irritable 
cough. 

Combined Local and Constitutional Effect. 

Under this heading it may be convenient to discuss the 
anaesthetic properties of chloroform, and this we will now 
proceed to do on the plan adopted generally throughout 
these pages. 



CHLOROFORM. 



165 



Physiologic a l. 

1. On Brain and Nervous 
System. — Chloroform has 
first a stimulating, and sec- 
ondly a sedative, action on 
the brain, a good deal of 
excitement and struggling 
taking place during the early- 
stages of inhalation, whilst, 
during the later, narcosis is 
complete, and the patient 
lies quiet and motionless. 
This condition resembles 
natural sleep in being asso- 
ciated with anaemia of the 
brain, but differs by its ren- 
dering the patient quite in- 
sensible to external impres- 
sions, including the most 
severe cutting operations, 
this effect being due to a 
paralysing influence of the 
drug on the ganglionic cen- 
tres of the sensory nerves. 

The reflex functions of the 
cord are also lulled to slum- 
ber, and, if the inhalation is 
pushed too far, paralysis of 
the respiratory centre may • 
ensue. 

2 . Heart and Circulation. 
— On the heart the influence 
of chloroform is at first 
slightly stimulating, the pulse 
becoming quickened ; but 
secondary depression fol- 
lows from a paralysing in- 
fluence on the sympathetic 
ganglia, the pulse now grow- 
ing slower, and the arterial 
tension becoming lowered. 

3. Respiration and Tein- 
perature. — The respiration 



Th erapeictical. 

In the early stage of in- 
halation the patient usually 
feels confused and giddy, 
his eyes are suffused, his face 
congested, and the heart 
beats rapidly. This is often 
followed by apparent insen- 
sibility, from which, how- 
ever, he can readily be 
roused, and very frequently 
a stage of violent excitement 
ensues, during which he 
struggles violently and with 
remarkable muscular force, 
talking and singing incohe- 
rently meanwhile. This 
stage has been described as 
that of alcoholic intoxica- 
tion. Succeeding to this we 
have that of ' anaesthesia,' 
in which he is profoundly 
insensible, with contracted 
pupils ; and finally we reach 
that of ' narcosis,' in which 
the face becomes congested, 
the pupils dilate, and sterto- 
rous breathing sets in. Chlo- 
roform inhalation is [only] 
used during its first stage to 
alleviate the pain of child- 
birth, it being found that 
full anaesthesia under these 
circumstances is apt to relax 
the uterine muscular tissues, 
and not only to check their 
contraction, but to predis- 
pose to future haemorrhage. 

During the second stage 
chloroform is used for the 
purpose of obtaining full 
and complete insensibility to 
pain during the performance 



i66 



CHLOROFORM. 



tends at first towards in- 
creased rapidity, but if the 
inhalation is pushed so far 
as to affect the respiratory- 
centre, the breathing grows 
slower, and finally ceases. 
We usually observe some 
tendency to perspiration at- 
tending chloroform inhala- 
tion, and a consequent slight 
reduction of temperature. 

4. On the digestive and 
secreting organs chloroform 
seems to exert no marked 
influence, the sickness so fre- 
quently observed during re- 
covery being purely reflex 
in character. 



of operations ; and this inva- 
luable property has deprived 
the practice of surgery of 
much of its former horrors. 

We also employ it freely 
to relax muscular tension 
and spasm, and so facilitate 
the reduction of hernia and 
dislocation ; for diagnostic 
purposes, in order to dispel 
phantom uterine tumors, as 
well as to enable us to make 
a careful examination of ex- 
tremely painful parts. 

It is also of service for 
the relief of various forms 
of spasmodic affections, as 
whooping-cough, infantile and 
puerperal convulsions, cho- 
rea, and to alleviate pain, in 
cancer, during the passage of 
renal or biliary calculi, and 
under many other condi- 
tions. 



Poisonous Properties. 



Chloroform may kill in 
two ways. (1) By primarily 
paralysing the heart, and this 
has generally been consider- 
ed to be due to the inhalation 
of air too highly charged with 
chloroform vapor, Mr. Clo- 
ver holding that over 5 per 
cent, must be considered 
dangerous. Dr. Brunton, 
however, explains very inge- 
niously how it is that small 
doses are more apt to pro- 
duce this effect than large, 
and thus shows us, what 
could hardly be understood 
before, why so considerable 



During chloroform-inha- 
lation we must watch the 
, pulse, and specially note en- 
feeblement, irregularity, or 
cessation of its beats. Sud- 
den pallor of the face, livid- 
ity, and gasping for breath 
are signs of ill omen. If 
the action of the heart seems 
to fail, we must administer 
stimulants by the mouth or 
rectum, and excite the cuta- 
neous surface. Galvanism 
seems more likely to exhaust 
than excite the contractility 
of the heart muscle ; and 
galvano-puncture, so much 



CHLOROFORM. 



167 



a proportion of chloroform 
deaths have occurred during 
the performance of very tri- 
vial operations. 

It seems highly probable, 
however, that, in accordance 
with the views of Syme, Lis- 
ter, Chiene, &c, fatal acci- 
dents from chloroform are 
not so liable to proceed from 
the heart as (2) from the 
respiratory function; and this 
mode of fatal accident has 
been again subdivided into 
two headings : 1st. Death by 
apncea, or stoppage of the 
breathing from nervous in- 
fluence or mechanical causes. 
2ndly. By suffocation from 
excessive formation of car- 
bonic acid in the blood. Of 
these, the first is by far the 
more common, and is often 
caused by falling back of the 
tongue, closing the glottis. 
It therefore follows that, 
whilst engaged in the admin- 
istration of chloroform, the 
breathing must be very care- 
fully watched. 

Absorption and Elimination. 

Chloroform is rapidly absorbed and rapidly given off by 
the breath and urine, in which secretion it can be readily 
detected. 

Mode of Administration. 

Fatal accidents from chloroform have become so alarm- 
ingly frequent of late, that some surgeons even consider 
its use unjustifiable ; but it is on the whole by far the best 
anaesthetic, and, by adopting the following precautions, 
we may hope to imitate the success of the Edinburgh 
School, where danger or inconvenience rarely occurs, 



vaunted by foreign observ- 
ers, has not been tried in 
this country. 

Chloroform accidents de- 
pending, in a great majority 
of cases, on failure of respi- 
ration, we must endeavor to 
re-excite this function by 
cold sprinkling or ammonia 
vapor, but most hopefully by 
the steady and persevering 
use of artificial respiration. 
Always, however, see that 
no mechanical hindrance to 
breathing exists, and more 
especially take care to draw 
the tongue well forward. 

Galvanic stimulation of 
the phrenic nerve has been 
recommended, and several 
apparently hopeless cases 
have been saved by the pro- 
cess of inversion as origi- 
nally proposed by Nelaton. 



l68 CHLOROFORM. 

Mr. Syme having met with no death during 8,000 admin- 
istrations. 

i. Never permit inhalation to take place in a sitting pos- 
ture, and see that the patient's neck is free from all con- 
striction. 

2. Give strict orders that no solid meal be taken for at 
least two or three hours previously [solid food should 
not be eaten for at least twelve hours, as a safe precaution], 
but a little beef-tea may be allowed, and a small sip of 
brandy is useful just before the operation. The sickness 
which so frequently attends a loaded stomach is not only 
inconvenient, but has proved fatal by suffocation from the 
drawing of vomited matters into the air-passages. And, 
in addition to this danger, vomiting is attended with 
special risks after such operations as ovariotomy and cata- 
ract extraction, and after the first of these it occasionally 
continues with exhausting pertinacity. 

3. Use no special form of inhaler, but pour the chloro- 
form freely on a towel or other porous material, and give 
it without fear [allowing a free admixture of the vapor 
with sufficient atmospheric air]. Tell the patient to close 
his eyes and to inspire deeply, and when the period of 
excitement comes on do not suspend the inhalation, but 
keep the towel firmly applied to the face until calm sleep 
is produced, or the slightest indication of stertor is heard. 
Complete anaesthesia is proved by abolition of reflex action, 
as shown by insensibility of the eye [when the cornea is 
lightly touched with the finger], by muscular relaxation, 
and by insensibility to pain. 

When the operation is over, let the patient recover 
naturally, and do not disturb his sleep by the purposeless 
towel flickings so frequently to be seen in operating thea- 
tres. [But the patient should be carefully watched for at 
least an hour after administration.] 

As regards the quantity of chloroform to be used for 
each inhalation, it is impossible to lay down any rule, for 
the inconveniences occasionally met with seem to bear no 
sort of proportion to the dose of the anaesthetic. [A 
couple of drachms may be poured from a dropping 
bottle upon the towel, and a few drops added from time 
to time to replace loss by evaporation. The chloroform 
should never be trusted to any but a skilled assistant.] 
If the chloroform be of good quality, it is safer, as shown 



IRISH MOSS — BLACK SNAKEROOT. 169 

by Brunton, to give it freely, and it is better to trust to 
our own care and skill than to the fancied safety of in- 
halers. It can never be possible to deprive an unnatural 
condition like profound anaesthesia of all dangers, and 
even the theoretically safe instrument of Clover, with its 
guaranteed 3 per cent, of chloroform vapor, has been 
shown to be not absolutely free from risks. 

It would be very satisfactory could we lay down any 
laws for our guidance in anticipating danger from chloro- 
form inhalation in any special class of cases, but this un- 
fortunately we cannot do. It is now well known that 
neither organic disease of the heart nor conditions of ex- 
treme debility are contra-indications ; and although fatty 
heart is frequently discovered post mortem, we cannot 
absolutely state that this is not a mere coincidence, nor 
can we pretend to diagnose such degeneration with any 
certainty during life. Some authorities believe that chlo- 
roform is more dangerous to the old than the middle-aged 
or young, and there seems no doubt that habitual topers 
are brought under its influence with considerable difficulty. 

Chloroform is most generally given internally under 
the form of the spiritus chloroformi, or chloric ether, in 
doses of from ttlx. to f3j- [or as Mistura Chloroformi]. 



[CHONDRUS— IRISH MOSS. 

Chon dr us crispus, U. S. 

Carrageen is demulcent and nutritive, and is used in 
decoction Qfss. to Oiij.) flavored with lemon, as a ptisan 
or drink for the sick. Boiled with milk it makes carra- 
geen blanc mange, an acceptable and nourishing article 
of diet for an invalid.] 



CIMICIFUGA— BLACK SNAKEROOT. 

[ The root of Cimicifuga racemosa, U. S. 

Officinal Preparation, U. S. 

Extractum Cimicifugae Fluidum. Dose, f^ss.-j. 

The decoction, although not officinal, has been used to 
a considerable extent, and with benefit, in the treatment of 
chorea in children. It is sedative and antispasmodic, and 
in large doses vomits.] 

15 



170 CINCHONA. 

This drug was introduced into practice in this country 
[England] some years ago by Sir"]. Simpson, who praised 
it highly in chronic rheumatism, lumbago, and hypochon- 
driacal depression. It has been found useful in America 
as an emmenagogue , but has never taken any real hold 
upon professional attention at home. 

Dose of the tincture [Br.], 10 to 30 minims. 



CINCHONA— CINCHONA. 

\_Syn. Peruvian Bark ; Cinchona Bark: The bark of all species of 
/he genus Cinfhona, containing- at least two per cent, of the proper 
cinchona alkaloids, which yield crystalline salts, U. S. 

Varieties. 

Cinchona Flava. The bark of Cinchona calisaya, U. S. 

Cinchona Pallida. The bark of Cinchona Condami- 
nea, and of Cinchona micrantha, U. S. 

Cinchona Rubra. The bark of Cinchona succirubra, 
U. S. 

Officinal Preparations, U. S. 

Of the Yellow Bark: — 

Cinchoniae Sulphas. Dose, gr. ij.-xxx. 
Decoctum Cinchonae Flavae. Dose, f.^ij.-iv. 
Extractum Cinchonae. Dose, gr. v.-xv. 
Extractum Cinchonae Fluidum. Dose, gtt. v.-xv. 
Infusum Cinchonae Flavae. Dose, f^ij, 
Quiniae Sulphas. Dose, gr. ij.-xx. 
Pilulae Quiniae Sulphatis (each gr. j.). 
Tinctura Cinchonae. Dose, f 3j. — ij. 

Of the Red Bark:— 

Decoctum Cinchonae Rubrae. Dose, fgij.-iv. 
Infusum Cinchonae Rubrae. Dose, f^ij. 
Tinctura Cinchonae Composita. Dose, f3j--ij-] 

Effects and Uses. 

In any comparative estimate of the absolute importance 
of various drugs to the human species, cinchona would 
probably take the second place, the first being, by univer- 
sal consent, accorded to opium. The actual bark itself, 
however, is not now of so much importance as in former 
years, when it was our sole dependable remedy for the 



CINCHONA. 171 

poison of ague, and was then given in such enormous 
quantities as to be very embarrassing to the weak stomachs 
of feverish patients. This difficulty is now happily removed, 
and much greater precision and efficiency given to our 
treatment, by the introduction of quinine, the discovery 
of which in 1820 inaugurated a true era in therapeutics. 

The preparations of cinchona are now used almost exclu- 
sively on account of their tonic properties, and in many 
cases of general debility, want of appetite, and loss of 
tone, most gratifying results are obtained by their employ- 
ment either singly or in combination. Quinine itself, 
however, has a higher and wider therapeutic range, and 
has in recent years obtained so much of the careful atten- 
tion of physiologists that we are bound to consider its 
properties with as much care and precision as the present 
state of science allows. 

Local Action. 

Quinine is occasionally, although rarely, used as a local 
application; but the theory of this is so intimately bound 
up with its internal use, that we need not refer specially to 
it at present. 

Internal Action. 

Physiological. Therapeutical. 

I. Nervous System. — 1. I. The subcutaneous injec- 
Brain. — Quinine in large tion of quinine has been 
doses causes curious brain highly recommended by 
symptoms, such as partial Surgeon-Major Hall in sun- 
blindness, well-marked deaf- stroke. 

ness and ringing in the ears, This mode of administer- 
giddiness, and frontal head- ing the drug, however, is not 
ache, associated with a pecu- unfrequently followed by in- 
liarly dull, heavy expression flammation and even abscess 
of countenance. Binz has at the seat of puncture, 
suggested that some at least The oxytocic action of 
of these phenomena may be quinine must be, in part at 
due to partial anaemia of the least, due to its action on the 
brain, caused by enfeebled nervous system ; but its un- 
action of the heart. doubted power in contract- 
It contracts the uterus. ing the uterus has not yet 
2. Spinal System. — In been much used in medicine, 
frogs, quinine acts power- [It appears to be appreciated 



172 



CINCHONA. 



fully in reducing the reflex 
irritability of the cord, the 
animal lying motionless, 
quite insensible to external 
impressions, the stillness be- 
ing only broken by occa- 
sional tetanic spasms. 

II. On Vascular System — 
Moderate doses of quinine 
increase the frequency of 
the pulse, but, if larger 
quantities be given, the 
rate of pulsation falls, the 
arterial tension diminishes, 
and death may even ensue 
from convulsions or sudden 
collapse following depres- 
sion of the heart's action. 

Quinine has a direct ac- 
tion on the white corpuscles 
of the blood, checking their 
amoeboid movements, and 
arresting their tendency to 
migrate through the walls of 
the capillaries under inflam- 
matory conditions. 

It also prevents, in some 
degree, the due giving up of 
oxygen by the red corpus- 
cles, and may thus interfere 
with the oxygenation of the 
tissues. 

III. Respiration and Tem- 
perature. — No influence on 
the respiratory function has 
been observed. On the 
temperature of a person in 
full health but little lowering 
effect is produced ; when 
fever is present, however, 
the temperature may be 
brought down by giving 
large doses. Opinions differ 



in the United States. Here 
it is frequently used as a 
parturifacient in single doses 
of gr. x.-xv.] 



II. Quinine has therefore 
some stimulating properties. 



An essential part of in- 
flammation and suppuration 
is now known to be extrusion 
of the white blood corpuscles 
from the capillaries, and their 
subsequent transformation 
into pus- cells. Quinine may 
therefore be of great service 
in localised inflammations, 
and in checking exhausting 
discharges from abscesses or 
wounds. 



III. The antipyretic pro- 
perties of quinine are much 
prized in Germany, and it 
is there largely used in the 
treatment of typhus, typhoid, 
acute rheumatism, and pneu- 
monia. 

Immense doses, even 
reaching 75 grains, have 
been given, and it is ob- 
served that tolerance of the 



CINCHONA 



173 



so much as to the explana- 
tion of this effect, that it is 
impossible to speak with 
any confidence on the ques- 
tion. [According to Hen- 
bach the cause of death in 
animals poisoned with quinia 
is a paralytic arrest of respi- 
ration.] 



IV. On Secretion. — In 
moderate doses, quinine in- 
creases the secretion of 
saliva, and augments, like 
most bitters, the flow of 
gastric juice, stimulating the 
appetite at the same time. 

If larger quantities, how- 
ever, are taken, an exactly 
opposite effect is produced ; 
hunger is blunted, and the 
alkaloid, acting as an irri- 
tant to the mucous mem- 



drug is undoubtedly present 
[in fever], and that very 
much larger quantities can 
be taken than in a state of 
health. It is only when very 
freely given, however, that 
it has any cooling influence ; 
and we are advised to pre- 
scribe from 25 to 45 grains 
in divided doses within the 
first half hour, as the effect 
would be diminished by 
spreading it over a longer 
time. 

In this country we do not 
make very extensive use of 
quinine in febrile disorders, 
for the resulting diminution 
of temperature is only tem- 
porary, and has no influence 
on the progress of the dis- 
ease. When a really dan- 
gerous degree of pyrexia is 
reached, we know that we 
can hold it readily in check 
by cold baths. [But where 
hydropathic treatment is in- 
admissible, quinia in full 
doses is an efficient anti- 
pyretic] 

IV. Quinine is the best 
tonic we possess, increasing 
the appetite, and bracing up 
the intestinal mucous mem- 
brane. It is given, there- 
fore, in all states of the 
system where debility is 
present, in simple loss of 
appetite, in some forms of 
dyspepsia, in neuralgia, es- 
pecially of the supra-orbital 
nerve, in convalescence 
from acute disease, to arrest 



174 



CINCHONA. 



brane of the stomach, checks 
the gastric juice. The urine 
is found to be unaltered in 
quantity, but the amount of 
uric acid and probably of 
urea given off is decidedly 
diminished. 

V. Quinine is an excellent 
antiseptic, preventing and ar- 
resting decomposition. This 
it does in virtue of its poi- 
sonous influence over minute 
organisms, for we know that 
the process of decay is caused 
by the formation and rapid 
multiplication, within the pu- 
trefying fluid, of microscopic 
bodies called microzymes. 
Quinine in small doses para- 
lyses, and in larger destroys, 
these creatures, and so at 
once arrests further destruc- 
tive action. 



the nocturnal sweating of 
phthisis, &c. 



V. In virtue of this poison- 
ous influence over proto- 
plasm and minute germs, it 
has been recommended in 
large doses in whooping- 
cough, on the ground of de- 
stroying the vitality of the 
thick and tenacious mucus 
which causes so much irrita- 
tion in the bronchial tubes, 
or, as others hold, by de- 
stroying the minute fungus 
on which the disease de- 
pends. [Henke.] Again, in 
hay -fever, which is now 
proved to result from the 
local action on the Schnei- 
derian mucous membrane of 
the pollen of particular grass- 
es, Professor Helmholtz has 
lately pointed out that qui- 
nine applied in the form of 
snuff or strong solution [gr. 
j.-f^j.], will effect a speedy 
cure. Some authorities have 
also been inclined to ex- 
plain its remarkable influ- 
ence over ague by theoreti- 
cally supposing that the es- 
sence of the malarial poison 
really consists in a minute 
germ or vegetable cell 
derived from the marshy 
land where the pestilence 
breeds, and that the antisep- 
tic property of the drug is 



CINCHONA. 175 

here the true explanation of 
its therapeutic success. But 
this is far-fetched and barely- 
probable. 

Specific Action. 

Quinine has what, for want of a better explanation, we 
must call a specific control over all malarial fevers and 
diseases which display any periodical tendency. 

Now quinine may act as a prophylactic, and, given in 
moderate doses at regular intervals, may ward off attacks; 
and this fact is extensively taken advantage of by African 
travellers and troops stationed in malarial districts, to 
whom rations of quinine are invariably served out. When 
the disease, however, is fairly developed, quinine will 
keep it in check and even arrest its progress ; and this 
either in smaller doses frequently repeated, or in one con- 
siderable dose taken shortly before the attack is expected. 

The periodical return of the paroxysms of shivering, 
heat, and sweating, enables us to calculate with accuracy 
the very hour of the day at which to expect their recur- 
rence ; and experience has determined that the best mode 
of treatment is to give one full dose of 10 or 20 grains 
half an hour before the attack comes on. 

The remarkable enlargement of the spleen which at- 
tends intermittent fever is often so rapidly diminished by 
quinine as to make it probable that the reduction of bulk 
is due to an active contraction of the substance of the 
organ itself. 

Another curious point about the action of quinine is, 
that whilst it may check the rigors and rise of tempera- 
ture attending the aguish paroxysm, the quantity of 
urinary water and urea excreted may be as much increas- 
ed as they always are during the attack. 

Quinine is also an invaluable agent in some of those 
affections which, without belonging directly to the aguish 
category, have something of the intermittent quality 
impressed on them ; for example, we often find that neu- 
ralgia and various forms of headache are distinctly perio- 
dic, and return at regular intervals. In such cases quinine ' 
works wonders, and may effect a cure with almost magical 
rapidity. 



176 cinchona. 

Mode of Elimination. 

Quinine, being possessed of considerable diffusive power, 
rapidly enters the blood, and is rapidly given out, the 
elimination beginning two hours after the drug is swallow- 
ed, and being nearly completed in six hours, by which 
time nearly all the quinine has been thrown out of the 
system. Although traces of its presence have been found 
in the saliva, sweat, and intestinal secretion, it is by the 
urine that the greater part is given off. 

Disadvantages of its Use. 

In addition to the headache, deafness, ringing in the 
ears, and other physiological phenomena, already noted, 
some cases have been recorded of a peculiar bright-red, 
scarlatinoid eruption, accompanied by intolerable itching 
and smarting, and followed by copious desquamation. 
And we must remember that idiosyncrasy here plays an 
important role, and that some persons cannot take a single 
grain without inconvenience. 

Therefore, as before advised, it is always well, before 
prescribing quinine, to ask our patient if he has ever taken 
it before. 

Mode of Administration and Dose. 

This drug is best prescribed in mixtures with a little 
nitric [or dilute sulphuric] acid, as tinctures do not dis- 
solve it well ; though, as Ringer says, it is really unneces- 
sary to combine acid, as the quinine is readily soluble in 
the acid of the gastric juice. But a little acid makes a 
more elegant mixture, by removing that turbidity which a 
certain quantity of the undissolved alkaloid necessarily 
imparts to a solution. The dose varies from about gr. j., 
which is the usual tonic dose, to 10, 20, 30 grains, or even 
more ; and although in this country a larger quantity than 
10 grains is perhaps rarely prescribed, it is clearly absurd 
to put the maximum dose, as in the British Pharmacopoeia, 
so low as this. 

[To avoid the bitter taste of quinia is absolutely neces- 
sary in some cases. For this purpose it is sometimes 
ordered in sugar-coated pills, or inclosed in cachets de pain. 
The powder may be given to children in a spoonful of 
syrup of red orange, or mixed with honey or molasses ; 



CINCHONA. 177 

it may also be taken in coffee, or simply suspended in cold 
water. The quinia may be enveloped in tissue paper and 
twisted tightly into a ball ; a little practice will enable an 
adult to deftly swallow such a bolus without tasting, and 
with but little inconvenience. The aromatic elixir of gly- 
cyrrhizin has been recommended as the best vehicle for 
the administration of the sulphate of quinia ; x but prepara- 
tions containing licorice, such as the officinal fluid extract 
of taraxacum, or the compound licorice mixture, are quite 
satisfactory for this purpose. Tannin has the power of 
disguising the taste of quinia, and, according to Rolander, 
it does not detract from its therapeutic properties. The 
following formulae will be found useful for the administra- 
tion of quinia in solution. 
For children — 

I£. Quinise sulphatis gr. xxiv. ; 

Acidi tannici gij. ; 

Syr. cinnamomi f § i i j . M. 

Capiat cochleare parvum ter in die. 



Or, as the disulphate — 




I£. Quiniae sulphatis 

Acidi sulphurici dil. 
Tr. cardamomi co. 
Syrupi q. s. 

Dose, f 5j. 


gr. xxiv. ; 

1 OJ • > 

adfgiij. M. 


Or, in a cough mixture — 




]$.. Quinise sulphatis 

Acidi sulphurici dil. 
Mist, glycyrrhizoe co 


gr. xxiv. ; 
q. s. ad solve 
. ad. fgiij. M 



Dose, a teaspoonful. 
In the declining stage of whooping-cough. 

For adults, any of the preceding prescriptions may be 
used, or we may give the following : — 

I£. Quiniae sulphatis gr. xlviij. ; 

Acidi sulphurici dil. q. s. ; 
Syr. limonis f^ij- j 

Aqua? q. s. ad f^vj. M. 

each drachm containing one grain of quinia. A more 
pleasant preparation would probably be obtained by sub- 
stituting Curacoa cordial for the lemon syrup. As a tonic 

1 Remington, Med. and Surg. Rep., vol. xxxvii. p. 88. Phila., 1877. 



178 CINCHONA. 

carminative, the following proves very acceptable in weak- 
ened digestion : — 

I£. Quiniae sulphatis gr. xlviij. ; 

Acidi sulphurici dil. q. s. ad solve ; 
Tr. gentianae comp. f §iv. ; 
Syr. zingiberis q. s. ad ffvj. M. 
Dose, a dessertspoonful before meals. 
Wine of aloes may be appropriately added, should con- 
stipation be present in the case.] 

R. Quiniae sulphatis gr. viij. ; 

Acidi nitrici diluti f 5ss. ; 

Tincturee aurantii f ^ss. ; 

Syrupi aurantii f|j. ; 

Aquae ad f § viij. M. 
Dose, f§j. ter die sumend. 

For a case of debility and want of appetite. 

Some persons, who object to sweets, prefer the syrup to 
be left out ; but it will usually be found an agreeable addi- 
tion. Quinine may also be given in the form of simple 
powder, dissolved in a glass of sherry, and when a large 
dose, such as 10 grs., is prescribed, it is more conveniently 
taken in simple suspension in distilled water. A very 
common plan is to order quinine with acid infusion of 
roses, but Squire has pointed out that a turbid and unsightly 
mixture is thus produced from the resulting tannate of qui- 
nine being insoluble in sulphuric acid ; whereas if the 
infusion be made with nitric acid, the mixture is ' bright 
and attractive in appearance.' 

Preparations. 

Pilulse quiniae. Containing sulphate of quinine and 
[honey, U. S., or] confection of hips [Dog Rose, Br.]. 
Dose, 2 to 10 grs. 

Tinctura quiniae [Br.]. A solution of quinine in tincture 
of orange-peel in the proportion of 1 in 60. Dose, f 3j- 
ad fjjss. This is a useful preparation. 

Vinum quiniae [Br.]. A solution of sulphate of quinine 
and citric acid in orange wine, the proportion being 1 in 
480. Dose, fjjss. ad f^j. 

In addition to quinia, however, other alkaloids and sub- 
stances have been detected in bark, some of which are of 
use in medicine. We have : — 

1. Quinic or kinic acid. 

2. Quino-tannic acid. 



CINNAMON. 179 

3. Cinchona red. 

4. Kinovin. 

These four have no therapeutic significance. 

5. Cinchonia has some febrifuge power. 

6. Quinidia has been reported as nearly equal to qui- 
nine in the foregoing respect [and is an efficient substitute 
for the more expensive salt]. 

7. Cinchonidia is only a little less efficacious, but causes 
an unpleasant dryness of the mouth. 

None of these preparations have been able to take the 
place of quinine, as they are weaker, less certain in action, 
and less agreeable ; and quinine, notwithstanding its com- 
paratively high price, still retains its position as our most 
reliable antiperiodic. 

The preparations of cinchona, as we said before, are 
principally used for their tonic properties ; and there is 
perhaps no more pleasant and effectual medicine of this 
class than the ordinary tincture of bark, whilst the decoc- 
tion or infusion is in very general use as a vehicle for more 
active drugs. 

Of the yellow bark we have the powder given in 15 gr. 
doses. 

1. Decoctum cinchonas [flavas], 1 in 16. Dose, f^j. ad 

2. Extractum cinchonas liquidum [Br.]. Dose, 10 to 30 
minims. 

3. Infusum cinchonas [flavas], 1 in 16. Dose, f^j. ad f ^ij. 

4. Tinctura cinchonas, 1 in 5. Dose, f3j. ad f3ij. 
[The elixir of cinchona flava, though not officinal, is an 

elegant preparation, and is much used. Dose, f^j.-iij.] 
Of the pale bark there is the powder. Dose, 10 to 60 

grs. _ 

Tinctura cinchonas composita. [Huxham's tincture.] 

Containing powdered [red] bark, bitter orange-peel, ser- 

pentaria, saffron, cochineal, proof spirit. Dose, ^ to 2 

drachms. 



CINNAMOMUM— CINNAMON. 

\_The prepared bark of Cinnamomum Zeylanicum (Nees Laurin), and 
of Cinnamonmm aromaticum [A T ees, ibid.), U. S. 

Oleum Cinnamomi. Dose, gtt. i.-ij. 



ISO COCHINEAL — COLCHICUM. 

Officinal Preparations, U. S. 

Tinctura Cinnamomi (Jjss. to Oj.). Dose, f3j.-ij. 

Aqua Cinnamomi — as a vehicle. 

Pulvis Aromaticus (cinnamon and ginger each 2 parts, 
cardamom and nutmeg each 1 part). Dose, gr. x.-xx. 

Confectio Aromatica (pulv. aromat. and honey). 

Spiritus Cinnamomi (oil |j. in Oj.). Dose, f3j.-ij. 
Also enters into : — 

l 

Acidum Sulphuriciim Aromaticum, Infusum Catechu 
Compositum, Spiritus Lavandulae Compositus, Syrupus 
Rhei Aromaticus, Tinctura Cardamomi Composita, Tinc- 
tura Catechu, and Vinum Opii.] 

Cinnamon is principally used for flavoring purposes, but 
also seems to have slight astringent properties, which make 
it useful in diarrhoea. [It has been also strongly recom- 
mended in uterine hemorrhage, given in substarfce, dose, 
gr. v.-x., or as a decoction made with milk.] 



[COCCUS— COCHINEAL. 

The female of Coccus cacti, U. S. 

It enters into Tinctura Cardamomi Composita. 

Cochineal has been considered to possess antispasmodic 
and anodyne properties, and has been recommended in 
wlwoping-cough (gr. yj,, s. t. d., to infants) combined with 
carbonate of potassium. It is also used in neuralgia. In 
pharmacy it is used as a coloring agent.] 



[COLCHICUM— COLCHICUM. 

Colchici Radix. The corm of Colchicum autumnale, 
U.S. 

Colchici Semen. The seed of Colchicum autumnale, 
U.S. 

Officinal Preparations, U. S. 

Extractum Colchici Aceticum (of the root). Dose, 
gr. j.-ij. 

Extractum Colchici Radicis Fluidum. Dose, nv.ij.- 
iv. 

Vinum Colchici Radicis (^vj. to Oj.). Dose, gtt. x.~ 
xv. As a purgative, nrxxx. 



COLCHICUM. 



181 



Extractum Colchici Seminis Fluidum. Dose, n^ij. 



-vj. 

Tinctura Colchici (of the seeds, =§ij. to Oj.). Dose, 
f5ss.-j. 

Vinum Colchici Seminis (of the seeds, ^ij. to Oj.). 
Dose, 3ss.-jss.] 

Internal Action. 



Physiological. 

The leading physiological 
action of colchicum is un- 
doubtedly directed to the 
intestinal canal, large doses 
causing free vomiting and 
copious purging of yellow- 
ish faeces containing a large 
quantity of bile. The action 
of the heart is usually some- 
what depressed, and it has 
been stated that the urinary 
secretion is augmented, but 
of this there is no very clear 
proof. 

[Colchicum increases the 
proportion of the urea and 
uric acid, as well as the 
amount of urine excreted by 
the kidneys, according to 
Prof. Christison, Dr. Mac- 
lagan, and others. 

The active principle is an 
alkaloid, colchicia, which is 
from 80 to 100 times stronger 
than the fresh corm.] 



Therapeutical. 

As the experiments of 
Rutherford have shown that 
colchicum increases the bil- 
iary secretion, it may be a 
useful adjunct to cholagogue 
pills, although its own pur- 
gative action is too violent 
to be encouraged. 

Its principal use is as a 
remedy for gout, more espe- 
cially the acuter forms, and 
here it never fails to remove 
pain rapidly, without, how- 
ever, in any way lessening 
the tendency to future at- 
tacks. How it acts is un- 
known, and we can only call 
it a specific. It is also very 
valuable in various diseases 
of gouty parentage, as in 
some forms of dyspepsia, 
bronchitis, &c. ; but in acute 
rheumatism it has been 
proved to exert rather a 
noxious than a beneficial 
influence. 



Dose and Mode of Administration. 

Colchicum may be given either in one or two full doses, 
or in smaller quantities spread over a longer time. Of 
these plans the former is probably the more effectual in - an 
acute attack of gout. The following formulae are suitable 
for various gouty conditions : — 
16 



162 COLOCYNTH. 

]J. Tinctura? colchici seminis T>|xx. ; 

Potassoe bicarbonatis gr. x; 

Aquae pimentse [Br.] f §j. 

Misce, fiat haustus ter die sumendus. 

I£. Tinctura? colchici seminis n\xv. ; 

Magnesia? carbonatis gr. vj.; 

Magnesia? sulphatis gr. xxx. ; 

Aqua? mentha? piperita? ad f§j. M. 
S. Ter die sumendus. 

I£. Extracti colchici acetici gr. x.; 

Pulveris digitalis, 

Extracti colocynthidis comp. aii £)j. 
Misce, fiant pilula? xx. Sumat unam bis terve in die. 

I£. Potassii iodidi, 

Ammonii carbonatis aa 9J- > 

Vini colchici f5j. ; 

Tinctura? scilla?, 

Tinctura? hyoscyami aii f5U- ; 

Aqua? camphora? ad f^iij. M. 

S. f^ss. ter die. 
Dr. Greenhow's formula for gouty bronchitis. 

[Scudamore's mixture: — 

I£. Magnesia? sulphatis §j . — Ij . ; 

Magnesia? 5lJ-> g r - x h > 

Aceti colchici f§j.— jss. ; 

Syrupi croci [Br.] f § j . ; 

Aqua? mentha? pip. f §x. M. 

Dose, f§ss.-jss. repeated every 2 hours in a paroxysm of gout until 
from four to six evacuations are produced in the 24 hours. 

The Acetum colchici was omitted from the Pharmaco- 
poeia in the last revision. It was made from the conn, and 
was only one-third the strength of the officinal wine of 
colchicum root.] 



COLOCYNTHIS— COLOCYNTH. 

\_The fruit, deprived of its rind, of Citrullus Colocynthis, U. S. 

Officinal Preparations, U. S. 

Extractum Colocynthidis (alcoholic). Used only in 
combination. 

Extractum Colocynthidis Compositum. gr. v.-xxx. 
Pilulae Catharticse Compositae. 1-3 pills.] 

Physiological A ction. Therapeutical A ciion. 

Colocynth produces a Colocynth is a drastic 

good deal of irritation of purgative, rapid and efficient 

the large intestine, causing in its action, and much used 



CONFECTIONS — HEMLOCK. 183 

profuse watery evacuations, as an ordinary remedy in 

and, if given in excessive habitual constipation and 

dose, even proving fatal by various dyspeptic condi- 

inflammationand ulceration, tions. 

It is found, however, that 

its drastic action, as well as 

the griping to which it 

occasionally gives rise, may 

be obviated by combination 

with aromatics and other 

purgatives. 

Mode of Administration. 

Colocynth is rarely, if ever, prescribed alone. The 
compound extract or pill, containing, in addition, aloes 
and scammony, is a useful formula; but the best mode of 
combination is undoubtedly that with either hyoscyamus 
or belladonna. 



[Confectiones. 

The officinal Confections are: — 

Confectio Aromatica Confectio Rosse 

" Aurantii Corticis " Sennas.] 

" Opii 



CONIUM— HEMLOCK. 

[Conii Folia. The leaves of Conium maculatum, U.S. 
Conii Fructus. The full-grown fruit of Conium macu- 
latum, gathered while yet green and carefully dried, U. S. 

Officinal Preparations, U. S. 

Extractum Conii Fructus Fluidum. Dose, n^i.-v. 
Extractum Conii (of the leaves). Dose, gr. i.-ij. 
Extractum Conii Alcoholicum (of the leaves). Dose, 

Succus Conii. 1 Dose, f 3ss.— j. 

Tinctura Conii (^ij. to Oj.). Dose, fjss.-j. 

Antidote. 
Atropia has been suggested as a physiological antidote.] 

1 [The class of Succi, U. S. P., only comprises Succus Conii and 
Succus Taraxaci.] 



184 



HEMLOCK. 



Local Action. 

Conium has been occasionally used in the form of poul- 
tice as an application to cancerous sores or tumors, and it 
is said that the severe lancinating pain common to these 
affections may thus be mitigated. 



Internal Actions. 



Physiological. 

1. On NervoiLs System. — 
i. Brain. — No effect is pro- 
duced on the brain proper, 
it having been observed in 
cases of poisoning, and 
notably in that of Socrates, 
and in a patient under Prof. 
Bennett's care, that the 
intellectual faculties are quite 
unimpaired to the last. 

Dr. John Harley, how- 
ever, is of opinion that a 
considerable portion of the 
action of conium is expended 
on the motor ganglia, and 
more especially the corpus 
striatum. 

2. Spinal Cord. — Pure 
conium has no special influ- 
ence on the spinal nervous 
system, but an alkaloid, 
conia, which it usually con- 
tains, has been proved to 
cause first exaltation, and 
finally depression, of the 
reflex function of the cord. 
[Dr. Christison thinks "that 
it acts upon the spinal mar- 
row, directly prostrating the 
nervous power, producing 
paralysis of the voluntary 
muscles, and destroying life 
by arresting respiration." 
— U. S. D.] 



Th erapeuticaL 



I. To this action Dr. 
Harley ascribes the benefi- 
cial influence of conium in 
chorea. Although in many 
cases we may derive real 
advantage from this remedy, 
it often fails, and in order 
to insure the full amount of 
benefit we must use large 
doses, and see that the drug 
is pure. Dr. Harley also 
recommends it in the nerv- 
ous twitchings met with in 
some cases of hemiplegia. 
Conium has been given with 
some benefit in the convul- 
sions of children. 

[From 10 to 15 drops of 
the alkaloid has caused 
death.] 



HEMLOCK. 



I8 5 



3 . On the Nerves. — Herein 
lies the true physiological 
action of conium. It acts 
firstly on the third nerve, 
causing drooping of the eye- 
lid, dilatation of the pupil, 
and sluggish and impaired 
movement of the eyeball. 
The influence then spreads 
to all the other motor or 
afferent nerves. A sensation 
of weight and enfeeblement 
of the legs, followed by 
staggering, is first experi- 
enced, and finally total 
paralysis is developed, the 
victim being entirely unable 
to move ; and so complete 
may this become, that asses 
in Italy which have fed on 
hemlock have been flayed 
alive without the possibility 
of resisting in any way. 
This paralysing influence is 
at first confined to the termi- 
nal extremities of the nerves. 

The sensory nerves are 
quite unaffected. 

II. Vascular System. — No 
effect is produced on the 
heart or circulation. 

III. Respiration and Tem- 
perature. — The breathing is 
at first unaffected, but, as the 
poisonous action of the drug 
goes on, the paralysis spreads 
to the respiratory centre, and 
death ensues from asphyxia. 

Some lowering of the tem- 
perature has been observed. 

IV. Secretion. — No influ- 
ence on secretion has been 
noted. 



3. Dr: Harley recom- 
mends its use in the violent 
spasm of the orbicularis met 
with in keratitis, but I have 
been unable to confirm this 
after careful trial. 

The remarkable power of 
conium in effecting muscular 
relaxation would indicate its 
use in a variety of spasmodic 
conditions. Thus, in laryn- 
gismus stridulus, trismus, 
spasmodic wry neck, spas- 
modic stricture, [hysteria, and 
insanity, ~\ and perhaps in 
the reduction of hernia and 
dislocation where any contra- 
indication to the use of 
anaesthetics exists, it seems 
worthy of trial ; and Dr. 
Handheld Jones recom- 
mends it highly in paralysis 
agitans. It must, however, 
be confessed that the thera- 
peutical success of conium 
by no means comes up to its 
physiological promise. 



6* 



l86 COPAIBA. 

Mode of Elimination. 

The presence of conium has been detected in the blood, 
and its elimination is effected by the breath and urine. 

Mode of Administration, Cautions, &c. 

It having been satisfactorily proved that the succus is 
the only reliable preparation of hemlock, it is not neces- 
sary for us to say anything about the tincture, extract, va- 
por, or compound pill. Unfortunately, however, it is 
often difficult to obtain an efficient succus, as it keeps ill, 
and cannot always be satisfactorily made. Disappoint- 
ments frequently occur both from this cause and from the 
smallness of the dose often given in accordance with the 
recommendation of the Pharmacopoeia. In order to ob- 
tain any decisive effect we must give [of some prepara- 
tions, as much as] from half an ounce to 3 or even 4 ounces, 
as. has been done by Dr. Harley, remembering that the 
limit of safety is reached when any interference with in- 
voluntary movement is observed, this being best indicated 
by enfeeblement of deglutition. 

Children bear conium remarkably well* I have given 
ounce doses to a girl of eight, and the late Dr. Anstie pre- 
scribed even larger quantities to a younger child, without 
the slightest development of physiological symptoms. [On 
account of the uncertainty of the strength of juice, it is 
best to begin with small doses, and carefully increase them 
until some narcotic effect is produced. Death has been 
caused by 150 minims of Squibb's fluid extract.] 



COPAIBA— COPAIBA. 

[ The oleo-resin of Copaifera mnltijuga {Haym} and of other 
species of Copaifera, U. S. 

Officinal Preparations, U. S. 

Oleum Copaibse. Dose, rr^viij.-xv. 

Pilulae Copaibse (each contains gr. jvss.). 3-5 pills.] 

Local Action. 

Physiological. llierapentical. 

Copaiba locally applied It has been used in this 

seems to act as a slight way in certain obstinate af- 

stimulant to the skin. fections of the skin, such as 

psoriasis; and in India it 



COPAIBA. 



I8 7 



seems to have been employ- 
ed with some success in lep- 
rosy and lupus, bearing as it 
does a considerable analogy 
to the gurjun oil which has 
lately acquired so high a re- 
putation in the treatment of 
the first-mentioned disease. 
Its nauseous smell, however, 
must always be a serious bar- 
rier to its use. 



Constitutional Action. 



1. Brain and Nervous Sys- 
tem. — No influence is exerted 
by copaiba on the brain, 
spinal cord, or nerves. 

II. Heart and Circula- 
tion. — No effect is produced 
on these organs, or on the 
respiration and temperature. 

III. Digestive and Secret- 
ing Organs. — 1. Stomach and 
Intestines. — Copaiba fre- 
quently causes most violent 
vomiting and purging. 

2. It has a stimulating ef- 
fect on mucous membranes 
generally, but more especi- 
ally on those of the genito- 
urinary tract, in virtue of 
which, after slight prelimi- 
nary irritation, it checks and 
finally arrests excessive dis- 
charges. 

3. Kid?ieys. — Copaiba, 
and more particularly the 
resin, increases very con- 
siderably the water of the 
urine without specially affect- 
ing the solid constituents. 

4. Copaiba, by internal 
ad ministration, seems to stim- 



Copaiba is an excellent 
remedy (t.) in gonorrhoea, 
where it may be given with 
great effect as long as the 
discharge continues thick 
and puriform. When the 
earliest inflammatory symp- 
toms have been subdued by 
alkalies and diluents, it will 
prove our best remedy, and 
it seems to act neither purely 
locally nor constitutionally, 
but in both ways conjointly, 
being altered in some way in 
the blood, and then exerting 
a topical influence on the 
affected mucous tract. (2.) 



155 COPAIBA. 

ulate the skin, and occa- It is also of service in chronic 
sionally produces an erup- cystitis, and in the later stages 
tion of bright red papules, of bronchitis, when profuse 
not unlike measles, usually and exhausting discharges 
beginning on the hands, have been established from 
spreading over the body, and the bronchial tubes. (3.) 
causing much tingling and As a diuretic, the resin has 
itching. been most highly praised by 

Dr. Wilks and Dr. F. Taylor 
in the dropsy of heart disease, 
in ascites, and in some forms 
of renal affections. (4.) Dr. 
Liveing, more especially, has 
drawn attention to the value 
of copaiba in psoriasis and 
other obstinate skin diseases. 

Absorption and Mode of Elimination. 

Copabia is very rapidly absorbed into the blood, as 
indicated by the communication of its nauseous smell to 
the breath and urine, by which channels it is principally 
eliminated. On the addition of nitric acid to the urine of 
patients taking copaiba, a milky appearance is produced 
by precipitation of the resin, and this is distinguished from 
albumen by the action of heat, which melts the resin and 
removes the deceptive cloud. 

Peculiarities. Mode of Administration. 

The digestive disturbance occasionally caused by copaiba 
prevents some persons from taking it at all, and the almost 
invincibly nauseous nature of its flavor and odor is a seri- 
ous drawback to its use. Capsules both of sugar and 
gelatine have been devised, which are frequently well 
borne ; but we must remember not only that these are 
often too large to be swallowed with comfort" by nervous 
persons, but that their use is apt to be followed by dis- 
agreeable eructation. No means have been proposed to 
obviate the measly and irritable rash which not unfre- 
quently appears on the skins of patients under the influence 
of copaiba; but various forms of prescriptions are in 
general use, and some of these are moderately effectual in 
concealing the offensive flavor of this useful drug. 



GOLDTHREAD — CORIANDER. 189 



R . Copaibae 

Liquoris potassae 
Misce, agitando, et adde — 


f5ss.; 
f3ss.; 


Mucilaginis acaciae 
Spiritus aetheris nitrosi 
Tincturae opii 
Aquae [menthae pip.] 
Fiat haustus ter die sumendus. 


f3ss.; 

ad f §j. 


For gonorrhoea. 




J£. Copaibae 

Syrupi tolutani 

Pulveris acaciae 

Acidi sulphurici aromat. 

Aquae destillatae 
S. f §ss. ter in die. 


f §ss. ; 
f §ss. ; 
§ss. ; 
I5ss.; 


For gonorrhoea. 




R. Resinae copaibae 
Alcohol 
Chloroformi 


f5J»; 


Mucilaginis acaciae 
Aquae 
Capiat semunciam ter in die. 


ad f ^xij. 


Formula for copaiba as a diuretic. 





M. 



M. 



[COPTIS— GOLDTHREAD. 

Coptis irifolia, U. S. 

Goldthread is an indigenous tonic bitter resembling 
quassia, for which it may be substituted. It may be given 
in substance (gr. x.-xxx.), infusion (3j.-0j. ; dose, fsj.- 
ij.), and tincture (3J.-OJ. ; dose, f3j.-ij.)- It contains 
berberina, but no tannin nor gallic acid, being a simple 
bitter without astringency.] 



[CORIANDER— CORIANDER. 

The fruit of Coriandrum Sativum, U. S. 

Enters into Confectio Sennas, Infusum Gentianse Com- 
positum, Infusum Sennae, and Tinctura Rhei et Sennas. 

Uses. 

Coriander seed is aromatic and stomachic (dose, 9j. to 
3J.) j it is rarely used except in combination.] 



I90 DOGWOOD — CUBEB. 

[CORNUS FLORIDA— DOGWOOD. 

The bark of Cornus Florida, U. S. 

Officinal Preparations. 

Decoctum Cornus Floridae. Dose, f^ij. 
Extractum Cornus Floridae Fluidum. Dose, f 3ss. 

Dogwood is an indigenous, astringent tonic, and has 
been recommended as an antiperiodic as a substitute for 
cinchona.] 

CREASOTUM— CREASOTE. 

\_A peculiar substance obtained from wood-tar, U. S. 

Officinal Preparations, U. S. 

Aqua Creasoti (nriij^. to foj)- Dose, f3j.-iv. 
Unguentum Creasoti (f 3ss. to lard 5j-)-] 

This drug [dose, gtt. i.-ij., diluted] is now but little 
used [owing to the difficulty of obtaining it pure, the com- 
mercial article being largely contaminated with impure 
carbolic acid] ; but is a useful remedy in some forms of 
sickness and vomiting, as an inhalation for ozczna and 
various lung diseases with foetid expectoration, and as a 
local application. in toothache. 

The mistura creasoti [Br.], containing nij. to the ounce, 
is a convenient mode of administration. [The ointment 
is used in scaly eruptions. ~\ 



[CRETA— CHALK. 

Native friable carbonate of calcium, U. S. {for preparations, see 

Calcium.}] 



[CROCUS— SAFFRON. 

The stigmas of Crocus sativa, U. S.~\ 
Saffron is never used, save as a coloring agent. 



CUBEBA— CUBEB. 

[The unripe fruit of Cub eb a officinalis, (Miguel), Piper Cubeba 
(Linn.), U. S. 

Officinal Preparations, U. S. 

Extractum Cubebae Fluidum. Dose, fjss.-ij. 
Oleo-Resina Cubebae (8 times the strength of the 
powder). Dose, t^x.-xxx. 



COPPER. 191 

Oleum Cubebse. Dose, gtt. x.-xij. 
Tinctura Cubebae. Dose, f5ss.-ij. 
Trochisci Cubebse (each contains gtt. j. of the oleo- 
resin).] 

Physiological Action. Therapeutical Action. 

Cubebs also has a stimu- Cubebs is occasionally used 
lating action on mucous in cystitis, but it has long 
membranes, and more par- been known as one of the 
ticularly on that of the blad- most efficient and generally 
der and urethra. In large prescribed remedies for gon- 
doses it causes considerable orrhcea, acting best during 
gastro-intestinal irritation. the acute stage of the disease. 

It has also been found use- 
ful when given in the form 
of lozenges for the relief of 
relaxed sore -throat. 

Dose of the powder 30 to 120 grs. ; tincture f3ss. ad 
f3ij. ; or of the oil nrv.-xx. 

CUPRUM— COPPER. 

[Cupri Subacetas. Impure subacetate of copper, 
U. S. 

Cupri Sulphas. Sulphate of copper, U. S. 
Cuprum. Copper wire, U. S. 

Officinal Preparations, U. S. 

Cuprum Ammoniatum. Dose, gr. %-%. Copper 
is also used in preparing Sp. iEtheris Nitrosi.] 

Antidotes. 

Albumen, ferrocyanide of 
potassium, followed by 
prompt evacuation of the 
stomach. 

Local Actions. 

Physiologic a I. Therapeutical. 

Copper has caustic and In the form of the familiar 
astringent properties both blue-stone, or sulphate of 
in substance and solution. copper, it is used as an ap- 
plication to venereal sores, 



192 



COPPER. 



ulcers in the throat, granular 
lids, to check exuberant gran- 
ulations, &c. ; and in solu- 
tion it is a good lotion for 
various ulcerative surfaces, 
gleet, &c. 

Internal Actions and Uses. 



Physiological. 

1 . Brain and JVervous Sys- 
tem. — Copper probably acts 
in some measure as a nervine 
tonic, but when given in 
larger doses peculiar symp- 
toms set in, not unlike those 
of lead poisoning, and con- 
sisting of headache, neural- 
gic pains, cramps, and even 
paralysis. 

2. Circulation and Respi- 
ration. — No special effect. 

3. Secreting Organs. — 
Copper causes prompt and 
effectual evacuation of the 
contents of the stomach, act- 
ing as a direct emetic. It 
has an astringent influence 
over the stomach and intes- 
tines, and this, if pushed too 
far, may end in gastroente- 
ritis. 



Th erapeuticaL 
1. Copper has been used 
in small doses in chorea, epi- 
lepsy, &c, but with no spe- 
cially marked benefit. 



3. Copper is not so much 
used, however, for an emetic 
as sulphate of zinc, because, 
if by any chance it be not 
rejected by vomiting, it is 
liable to cause inflammation 
of the stomach. 

Sulphate of copper is a 
good astringent in advanced 
and obstinate diarrhoea. 



Mode of Elimination. 

Copper is eliminated chiefly by the liver and kidneys, 
the intestinal canal, and the salivary glands. 

Poisonous Effects. — As al- 
ready seen, copper may act 
as a poison by causing in- 
flammation of the stomach 
and intestines, as well as re- 
mote nervous symptoms. 

Sulphate of copper is the only salt of the metal used in 
medicine, and is prescribed in the following doses: — 



DECOCTIONS FOXGLOVE. 193 

I£. Cupri sulphatis 

Pulveris opii aa gr. ss. ; 

Extracti gentian se gr. iij. ; 

Misce, fiat pilulse nocte maneque sumenda. 

In a case of obstinate diarrhoea. 

[As an emetic, sulphate of copper is given in doses of 
gr. ij.-v.] 

[Decocta. 

The officinal Decoctions are — 

Decoctum Cetrariae, Decoctum Hsematoxyli, 
" Chimaphilae, " Hordei, 

" Cinchonae Flavse, " Quercus Albae, 

" Cinchonae Rubrse, " Sarsaparillae Comp., 

" Cornus Floridse, " Senegae, 

" Dulcamarae " Uvae Ursi.] 



DIGITALIS— FOXGLOVE. 

[ The leaves of Digitalis purpurea, from plants of the second 
year'' s growth, U. S. 

Dose, in substance, gr. ss.— ij. 

Officinal Preparations, U. S. 

Digitalinum (active principle). Dose, gr. ^. 
Extractum Digitalis. Dose, gr. ^ 



i/_i 



2 



Extractum Digitalis Fluidum. Dose, nrj.-ij. 
Infasum Digitalis (3ij. to Oj.). Dose, f3ij.-iv. 
Tinctura Digitalis (^ij. to Oj.). Dose, ni^v.-x.] 

Antidotes. 

After evacuation of the 
stomach and the administra- 
tion of tannin, we must ob- 
viate the tendency to death 
by stimulants, and by keep- 
ing the patient rigidly to 
the horizontal posture, as 
syncope is readily excited 
by suddenly sitting up. 

Aconite and atropia have 
been recommended as phy- 
siological antidotes, but we 
have as yet no evidence of 
their efficacy. 

17 



i94 



foxglove. 
Local Action. 



Physiological. 



Digitalis has been said to 
possess sedative properties 
when locally applied, and 
there is no doubt that it is 
rapidly and efficiently ab- 
sorbed by the skin. 



Th erapeutical. 

Digitalis has been used as 
a local sedative in cases of 
joint-inflai7imation, and the 
application to the legs of 
spongio-piline soaked in a 
strong infusion has been 
found to produce diuresis 
where other remedies have 
failed. 



Constitutional Action. 



I. Brain and Spinal Cord. 
— On the brain no direct ef- 
fect is produced, but the re- 
flex irritability of the spinal 
cord seems to be somewhat 
lessened under the toxic ac- 
tion of the drug. 

Stimulation of some por- 
tions of the vaso-motor and 
pneumogastric nerves seems 
to take place, as we shall 
explain more fully when 
treating of the influence of 
digitalis over the heart. 



II. Heart and Circulation. 
Digitalis exerts a decidedly 
tonic and strengthening in- 
fluence on the heart, render- 



I. Although no direct ac- 
toin is produced on the brain 
tissue, it is reasonable to sup- 
pose that some alteration in 
cerebral function may follow 
the alterations in the vascular 
system produced by digitalis, 
and perhaps this may in part 
explain the remarkable re- 
sults obtained by Mr. Jones, 
of Jersey, in the treatment of 
delirium tremens by the use 
of this drug. He found that 
half- ounce doses of the tinc- 
ture quieted the delirium, 
reduced fever, and caused 
sleep. But this treatment 
can hardly be recommend- 
ed, as several sudden deaths 
have been thus produced, 
and as it seems not improba- 
ble that the absence of toxic 
effects in many cases is due 
to the very partial absorp- 
tion of the remedy. 

II. The undoubted effect 
of digitalis in slowing and 
strengthening the action of 
the heart, would seem to in- 



FOXGLOVE. 



195 



ing its beats slower and more 
forcible, and lengthening the 
period of systole. This result 
seems to depend partly on a 
direct action on the heart's 
muscle itself, but also in some 
degree on stimulation of the 
cardiac inhibitory fibres of 
the vagus, which thus hold 
more forcibly in check the 
rapid rate of pulsation pro- 
duced by the sympathetic 
nerves. If, however, the 
administration of the remedy 
be too long continued, ex- 
haustion of the pneumogas- 
tric is apt to follow this over- 
stimulation, and the heart, 
being now handed over to 
the unrestrained power of 
the vaso-motor nerve supply, 
runs riot in excessively rapid 
and feeble contractions. 

The tonic influence of digi- 
talis is attended by well- 
marked rise of arterial ten- 
sion, and this is supposed to 
depend on stimulation of the 
sympathetic centres directly 
supplying the smaller vessels; 
and at the same time the 
heart is induced to act more 
powerfully, to overcome the 
increased resistance in front. 



dicate its use in certain dis- 
eased conditions of that or- 
gan, but it is only recently 
that this tonic influence has 
been recognized. In former 
years digitalis was looked 
upon as essentially a cardiac 
sedative, and was used to 
quiet the tumultuous palpita- 
tion of hypertrophy ; but we 
now know that it may be 
prescribed with much greater 
success under the following 
circumstances : — 

1 . In palpitation and irre- 
gular action of the heart, 
whether depending on or- 
ganic disease or not, an im- 
portant indication for its use 
being intermittence, or the 
occurrence of frequent beats 
which do not reach the pulse. 

2. In mitral disease, where 
the cardiac action is feeble, 
and apparently unable effect- 
ually to propel the blood, 
where lividity and dropsy 
are setting in, the lungs be- 
coming engorged, and the 
right heart oppressed. 

Here we shall derive the 
mostsignal service from digi- 
talis given in moderate doses, 
and combined with a little 
iron. Dr. B. Foster ascribes 
some of the good effect of 
digitalis in mitral disease to 
its slowing action, giving 
more time for the auricle to 
empty itself fully of its con- 
tained blood. 

The contracting effect of 
digitalis on the arterioles 
would naturally suggest its 



19* FOXGLOVE. 



use in haemorrhage, and it 
has accordingly been found 
of service both in haemoptysis 
and Menorrhagia ^ although 
in neither is it so efficacious 
as ergot. 

3. In dilatation of the 
heart, where the weak and 
thin muscle acts feebly and 
irregularly, giving rise to 
palpitation and breathless- 
ness, and causing temporary 
bruits by unequal and in- 
effectual closure of the mitral 
and tricuspid valves. 

4. In aortic disease, when 
compensation has not been 
made complete by hyper- 
trophy. 

In short, we may use 
digitalis whenever the heart 
is acting feebly and irregu- 
larly, but by its use we can- 
not expect to spur on a 
normally constituted heart 
with sound muscle to over- 
come difficulties in front, 
and we must avoid its regu- 
lar use in the compensatory 
hypertrophy of aortic dis- 
ease, and in fatty degenera- 
tion, where its tightening 
effect on the smaller vessels 
throws an injuriously-in- 
creased amount of work on 
the structurally -damaged 
organ. 

5. Ringer has drawn at- 
tention to the beneficial ac- 
tion of [the temporary use 
of] digitalis in relieving the 
distressing attacks of palpita- 
tion so often due to hyper- 
trophy of the heart. 



FOXGLOVE. 



197 



III. Respiration and Tem- 
perature. — On respiration no 
effect is produced, and al- 
though, in a state of health, 
digitalis does not lower the 
body heat, it undoubtedly 
possesses this influence over 
febrile conditions, Wunder- 
lich and others bringing 
ample evidence to prove its 
power of reducing tempera- 
ture in pneumonia, enteric 
fever, acute rheumatism, and 
other acute disorders. 



IV. Digestive and Secret- 
ing Organs. — 1 . Siom ach and 
Intestines. —From its bitter 
taste, digitalis might be cre- 
dited with some tonic proper- 
ties ; but it is really much 
more likely to disorder than 
to increase the appetite, by 
causing vomiting. 

It does not seem to affect 
the intestinal tract in any 
way, save in the later stages 
of poisoning, when diar- 
rhoea may supervene. 

2. Kidneys. — Digitalis in- 
creases, under certain condi- 
tions, the flow of urine with- 
out altering in any essential 



III. Digitalis has been 
found of great service in 
those cases of bronchitis 
which are so frequently 
associated with a weak and 
dilated right heart, and 
where stimulation of the 
cardiac muscle leads to a 
better arrangement of circu- 
lation through the lungs. 

For the reduction of tem- 
perature, digitalis is seldom 
used in this country, but in 
Germany its antipyretic vir- 
tues are prized. It seems, 
however, to lower the body 
heat without influencing the 
course of the disease ; and 
as it must be given in large 
doses, which may derange 
the digestive functions even 
if they do not prove directly 
dangerous, there does not 
seem to be any real benefit 
following its employment. 



2. Digitalis is a good diu- 
retic, more especially in car- 
diac and acute renal dropsy, 
and acts best in combination 



i7 : 



ig8 



FOXGLOVE. 



respect the quantity or pro- 
portion of its solid ingredi- 
ents. Its diuretic action 
depends partly on the tight- 
ening effect on the arterioles, 
raising the blood pressure 
in the renal glomeruli, and 
partly on the increased power 
and regularity of the heart, 
improving the general con- 
ditions of circulation within 
the kidneys. One curious 
point in this connection is, 
that digitalis will seldom 
produce diuresis in healthy 
persons, but always acts best 
when dropsical accumula- 
tions have to be removed. 

V. Uterus. — Digitalis, 
from its action on unstriped 
muscular fibre, has the pro- 
perty of stimulating the ute- 
rus to contraction. 



Poisonous Effects. — Digi- 
talis kills by tetanising the 
heart muscle, causing rapid 
and irregular action, follow- 
ed by arrest of action. The 
face grows pale, the pupils 
dilate, vomiting and diar- 
rhoea supervene, and death 
usually occurs by syncope. 
Cases of poisoning, however, 
are rare, and most of our 
knowledge under this head- 
ing has been derived from 
experiments on animals. 



with squill and mercury, as 
in the famous Guy's pill. 
The theory of this action, 
depending on heightened 
blood pressure within the 
Malpighian tufts, explains 
the frequent failure of digi- 
talis to augment the quantity 
of the urine in chronic kid- 
ney disease, where the arte- 
rial tension is already high. 



V. It has therefore been 
used to contract the uterus 
and thus check flooding or 
me?wr?'hagia, and it may also 
act by restoring its normal 
functions when these are sus- 
pended, as in amenorrhoza. 



Cautions, Mode of Administration, &c. 

In prescribing digitalis, we are generally advised to sus- 
pend its use from time to time, lest ' accumulation' lead 



BITTERSWEET. I99 

to poisonous symptoms ; but Dr. Fothergill, an excellent 
authority, repudiates this notion, and his experience in this 
direction is large. [See Physiological Effects, p. 195.] 

As regards the best form for its administration, the 
freshly made infusion is usually preferred, given in doses 
of from 2 to 4 fluid drachms. 

Of the tincture we may give from 5 to 10 minims ; of the 
powdered leaves, ^ gr. to 2 grs. 



R. Tinct. digitalis 


m,x.; 


Sp. seth. nit. 


f 3*. ; 


Inf. buchu 


f Ij- M 


S. Ter in die. 





Recommended by Fothergill in simple cardiac debility 
with scanty flow of urine. 

R. Pulv. digitalis gr. xxx. ; 

Ferri sulph. exsic. gr. xv. ; 

Pulv. capsici gr. xl. ; 

Pil. aloe et myrrhse gij. M. 
In pil. lx. div. Una bis in die. 

Recommended by Fothergill in cardiac debility, gastric 
catarrh, and inactivity of the bowels. 

R. Tinct. ferri chloridi TJIxv. ; 

Glycerin i f 5i- ; 

Infusi digitalis ^5'j-j 

Syrupi limonis f ^ i j . ; 

Infusi calumbse ad f^j. M. 
S. Ter die sumend. 

Cardiac tonic. 



DULCAMARA— BITTERSWEET. 

[The young branches of Solatium Dulcamara, U. S. 

Officinal Preparations, U. S. 

Decoctum Dulcamarse (ij. to Oj.). Dose, fjjss.-ij. 
Extractum' Dulcamarae (alcoholic). Dose, gr. x.-xx. 
Extractum Dulcamarae Fiuidum. Dose, f 5ss.-ij. 

Dulcamara is a feeble narcotic, formerly recommended 
in mania, rheumatism, and cutaneous diseases. At present 
it] is never used [to any great extent in regular practice]. 



200 



ELATERIUM — PLASTERS. 



ELATERIUM— ELATERIUM. 

[A substance deposited by the juice of the fruit of Momordica elaterhtm, 
Ecbalium agreste (jRichard), CI. S. 



Elaterium. Dose, gr. 



(Dose of Clutterbuck's 



elaterium, gr. 



Elaterin (not officinal). Dose, gr. t V _ tV] 



Physiological Ac lions. 

Elaterium produces irrita- 
tion of the intestine, ending 
in inflammation where in- 
cautiously pushed, and 
causes the evacuation of 
large quantities of watery 
fluid. It purges equally 
powerfully when injected 
below the skin or taken by 
the mouth, but it is stated 
that solution in the bile is 
necessary to develop its full 
action. In some of the 
lower animals, peculiar 
nervous symptoms follow its 
use, and vomiting and great 
depression are liable to be 
produced in the human sub- 
ject even by moderate doses. 
[It is probably our most 
efficient cathartic, in the 
treatment of dropsical dis- 
eases, especially after the 
failure of other remedies.] 



Therapeutical Effects. 
Elaterium is the most 
powerful hydragogue ca- 
thartic with which we are 
acquainted, and as such has 
been used to withdraw 
watery fluids from the intes- 
tines in various forms of 
cardiac disease, lightening 
the labors of the heart by 
lessening the volume of the 
blood, and relieving the 
cellular tissue and various 
cavities of dropsical accu- 
mulations. As, however, 
it is uncertain and very 
depressing in its action, it 
is now rarely used, in com- 
parison with compound 
jalap powder, which seems 
to fulfil the same useful 
indications without an equal 
chance of seriously weaken- 
ing the patient. 



Emplastrum Aconiti 

" Ammoniaci 



[Emplastra. 

The officinal Plasters are : — 

Emplastrum Hydrargyri 
Opii 

Picis Burgundicas 
" Canadensis 
" cum Cantharide 
Plumbi 
Resinae 
Saponis.] 



" cum Hy- 

Antimonii [drargyro 

Arnicas 

Assafcetidse 

Belladonnas 

Ferri 



Galbani Compositum 



ERGOT. 



20I 



ERGOTA— ERGOT. 

\_The sclerotium of Claviceps purpurea (Tulasne), replacing the 
grain of Sec ale cereale, U. S. 

Officinal Preparations, U. S. 

Extractum Ergotse Fluidum. Dose, n^x.-f5j. 
Vinum Ergotae (f^ij. fid. ext. in Oj). Dose, f§ss.— ij. 
(Ergotine — not officinal, is a purified extract. Dose, 
jr. v.-x.).] 

External Action. 

Ergot has no local action. 

Internal Actions. 



Physiological. 
i. On Nervous System. — 
No special action on any part 
of the nervous system has 
been proved. 



2. On Vascular System. — 
Ergot slightly depresses the 
action of the heart, and re- 
duces the number of its pul- 
sations, and it is said that the 
arterial tension is at first low- 
ered in some slight degree. 
This effect, however, rapidly 
passes away, and a decided 
rise in arterial tension follows 
the contracting influence of 
the drug on the arterioles. On 
examining the web of an er- 
gotised frog's foot, we may 
distinctly observe the gra- 
dual contraction of the small- 



Th erapeutical. 

i. Dr. Brown-Sequard ad- 
vises the use of ergot in some 
forms of paraplegia, unat- 
tended by irritation, and 
where inflammatory symp- 
toms have subsided, believ- 
ing that it acts well by con- 
tracting the dilated vessels. 
Dr. Crichton Browne has 
recently prescribed ergot 
with success in some forms 
of chronic mania. 

2. Ergot is now allowed 
to be by far the best astrin- 
gent in cases of internal 'hem- 
orrhage, and more especially 
in menorrhagia, hemoptysis, 
and epistaxis, the use of the 
liquid extract having quite su- 
perseded the older treatment 
by means of acids, gallic acid 
and the like, whilst, if a more 
rapid action is required, we 
may subcutaneously inject 
ergotine. [It has also been 
injected into internal haem- 
orrhoids with success.] 

It is also a valuable remedy 



202 



ERGOT. 



er vessels up to absolute 
obliteration of their calibre ; 
and this is believed to be due 
to a primary action of the 
ergot on their muscular walls 
rather than to the interven- 
tion of the vaso-motor sys- 
tem. Thus we observe a di- 
rect contrast to the action of 
the nitrite of amyl. 



3. Respiration and Tem- 
perature. — No special action. 

4. Urina7'y Functions. — 
Ergot, from its specific action 
on unstriped muscular fibre, 
tends to contract the bladder, 
and, by raising the tension 
in the Malpighian bodies of 
the kidneys, it increases the 
urinary flow. 



5. Digestive Organs. — 
Ergot occasionally causes 
sickness, vomiting, and di- 
arrhoea ; but constipation is 
more likely to follow its use, 
from its contracting influence 
on the intestinal capillaries. 

6. Uterine Functions. — 
Ergot has a remarkable and 
almost selective influence on 
the uterus, contracting its 
muscular walls, promoting 
its functions, and encourag- 
ing the expulsion of its con- 
tents. 



in purpura. Von Langen- 
beck, of Berlin, has advo- 
cated the injection of ergo- 
tine for the obliteration of 
aneurismal 'sacs, ,but sufficient 
evidence has not yet been 
brought forward of the suc- 
cess of this practice ; and it 
has also been advised in the 
case of old varicose veins. 
The gangrenous form of er- 
gotismus is doubtless due to 
arterial contraction cutting 
off the supplies of blood to 
the extremities. 



4. Ergot has been used 
successfully, and more espe- 
cially when combined with 
iron, in that most trouble- 
some affection, i?icontinence 
of urine; but, in my own ex- 
perience, belladonna is more 
deserving of confidence. 
Ergot has been recommend- 
ed as a diuretic. 

5. Ergot has been success- 
fully prescribed in cases of 
diarrhoea and dysentery. 



6. Ergotactsasanecbolic, 
expelling the contents of the 
uterus by causing contrac- 
tion of its muscular walls. It 
must only be used, however, 
where no disproportion ex- 
ists between the child and the 
maternal passages, and where 
we are prepared to render in- 
strumental aid at once, if 



ERGOT. 203 

necessary, when the pains 
have been aroused. We must 
also remember that its pro- 
longed use is apt to endanger 
the life of the child by cut- 
ting off its supplies of blood 
through the placenta. 

Ergot is also of service in 
flooding, in reducing the size 
of hypertrophied or subin- 
voluted wombs, and in pro- 
moting the destruction of 
submucous polypi, either by 
cutting off their supply of 
blood, or by squeezing them 
out of the uterine cavity. It 
is also an excellent remedy 
for amenorrhea and some 
forms of leucorrhoea. 

Mode of Administration, Dangers, Cautions. 

In those countries where ergotised rye largely prevails, 
two forms of disease attend its use. 1. The gangrenous 
form of ergotismus, where extensive dry gangrene of the 
nose, face, and extremities supervenes; and, 2. The spas- 
modic variety, where the victim is afflicted with most 
violent and agonising spasms. The therapeutic use of 
ergot, however, is of course never productive of any such 
symptoms, and the only inconvenience occasionally ob- 
served is some digestive derangement, with colicky ab- 
dominal pain. 

Three preparations are officinal: — 

Extractum ergotse liquidum [fluidum]. Dose, n^x. ad 

f3j. 

Infusum ergotse [Br.]. Dose, f^j. ad f ^ij. 

Tinctura ergotse [Br.]. Dose, tii,x. ad f 5j- 

The powder is also used in doses of from 20 to 30 grs., 
and many experienced authorities recommend a fresh in- 
fusion made with the powder and swallowed. 

Ergotine may be employed by subcutaneous injection 
in doses of 4 grains, but this process has the drawback of 
causing a painful, black, and unsightly lump at the seat of 
puncture. 



204 FLEABANE THO ROUG H WO RT . 

]$.. Extracti ergotas liquidi [Br.] f5'j«> 

Decocti aloes compositi [Br.] ad f §viij. M. 
Fiat mistura, de qua capiat unciam unam bis in die. 
Useful in amenorrhea. 

J$l. Pulveris ergotae ^j.; 

Sacchari 5^ v « j 

Aquae bullientis f §iij. M. 

Capiat cochlearia duo magna quarta quaque parte horse 
ad effectum. 
In a case of labor. 

In a case of amenorrhoea from anaemia we may add a 
little ergot to any chalybeate mixture. 



[ERIGERON— FLEABANE. 

The leaves and tops of Erigeron heterophyllum and of Erigeron 
Philadclphicum , U. S. 

Erigeron Canadense. The leaves and tops of Erige- 
ron Canadense, U. S. 

Officinal Preparations, U. S. 

Extractum Erigerontis Canadensis Fluidum. Dose, 
fgss.-j. 

Oleum Erigerontis Canadensis. Dose, gtt. v. 

Is diuretic, tonic, and astringent. It is chiefly used in 
hemorrhage in the form of the oil (dropped on sugar) gtt. 
v.-xx., repeated every two or three hours; or a tincture 
may be employed. An infusion has also been used in 
dropsy, and in genito-nrinary affections. ~\ 



[EUPATORIUM— THOROUGHWORT. 

The tops and leaves of Eupatorium perfoliatum, gathered after flowering 
has conunenced. U. S. 

Officinal Preparation, U. S. 

Infusum Eupatorii. Dose, f^j.-ij. 

Thoroughwort (Boneset) is a bitter tonic and sudorific, 
and in large doses produces vomiting and purging. The 
hot infusion has been largely given for "colds" muscular 
rheumatism, and catarrh. The infusion is emetic in doses 
of a pint. Dose of the powder as a tonic, in dyspepsia, 
gr. xx-xxx.] 



EXTRACTS — WHEAT FLOUR. 



205 



[Extracta. 



The officinal Extracts are: — 



Extractum Aconili 
Arnicae 
Belladonnse 

" Alcoholicum 

" Radicis Fluidum 
Buchu Fluidum 
Calumbae Fluidum 
Cannabis Americanse 

" Indicae 
Chimaphilae Fluidum 
Cimicifugae Fluidum 
Cinchonae 

" Fluidum 
Colchici Aceticum 

" Radicis Fluidum 

" Seminis Fluidum 
Colocynthidis 

" Compositum 
Conii 
" Alcoholicum 
" Fructus Fluidum 
Cornus Floridse Fluidum 
Cubebse Fluidum 
Digitalis 

" Fluidum 
Dulcamaras 

" Fluidum 

Ergotas Fluidum 
Erigerontis Canadensis 

[Fluidum 
Gelsemii Fluidum 
Gentianas 

" Fluidum 
Geranii Fluidum 
Glycyrrhizas 

" Fluidum 

Gossypii Radicis Fluidum 
Haematoxyli 
Hellebori 
Hydrastis Fluidum 
Hyoscyami 



Extractum Hyoscyami Alcoholicum 
" Fluidum 
Ignatias 

Ipecacuanhas Fluidum 
Jalapae 
Juglandis 
Kramerias 

'" Fluidum 
Lupulin33 Fluidum 
Matico Fluidum 
Mezerei Fluidum 
Nucis Vomicae 
Opii 

Pareirae Fluidum 
Physostigmatis 
Podophylli 

Pruni Virginianae Fluid. 
Quassias 
Rhei 

" Fluidum 
Rubi Fluidum 
Sabinae Fluidum 
Sarsaparillae Fluidum 

" Compositum Flu. 
Scillae Fluidum 
Senegae 

" Fluidum 
Sennas Fluidum 
Serpentariae Fluidum 
Spigeliae Fluidum 

" et Sennae Fluid. 
Stillingiae Fluidum 
Stramonii Foliorum 

" Seminis 

Taraxaci 

" Fluidum 
Uvae Ursi Fluidum 
Valerianae 

" Fluidum 

Veratri Viridis Fluidum 
Zingibei'is Fluidum.] 



FARINA TR1TICI— WHEAT FLOUR. 



Flour is only of dietetic importance. 
(Mica panis) is used as a vehicle for pills. 
18 



Bread-crumb 



206 YEAST — IRON. 

[FERMENTUM -YEAST. 

A peculiar insoluble product of the fermentation of malt liquors, U. S. 

Yeast is tonic, stimulating, slightly nourishing, and lax- 
ative. It contains alcohol, gluten, carbonic acid, and 
bitter extractive from hops, and has been given, in doses 
of a pint, daily in low fevers attended with irritable stomach. 
It has also been used in diabetes and boils. Mixed with 
flaxseed meal or other farinaceous substances, it forms the 
yeast poultice, which is much used in gangrenous ulcers. ~\ 



FERRUM—IRON. 

[Ferri Hypophosphis. Hypophosphite of iron. Dose, 
gr. v.-x. 

Ferri Sulphuretum. Protosulphuret of iron prepared 
by melting together sublimed sulphur andiron in small pieces, 
If. S. (Used only to make Hydrosulphuric acid.) 

Officinal Preparations, U. S. 

Ferri Chloridum. Dose, gr. v.-x. 
Liquor Ferri Chloridi. Dose, n^ij.-x. 
Tinctura Ferri Chloridi. Dose, nvx.-xl. 
Ferri Citras. Dose, gr. v.-xx. 
Liquor Ferri Citratis. Dose, r^x.-xl. 
Ferri et Ammonii Citras. Dose, gr. v.-x. 
Ferri et Ammonii Sulphas. Dose, gr. iij.-xij. 
Ferri et Ammonii Tartras. Dose, gr. x.-xxx. 
Ferri et Potassii Tartras. Dose, gr. x.-xxx. 
Ferri et Quinise Citras. Dose, gr. v.-xv. 
Ferri et Strychniae Citras. Dose, gr. iij.-v. 
Ferri Ferrocyanidum (Prussian blue). Dose, gr. v. 
Ferri Lactas. Dose, gr. ij.-x. 
Ferri Oxalas. Dose, gr. ij.-v. 

Ferri Oxidum Hydratum. Dose, gr. v. (As an an- 
tidote, gr. xx. for each grain of arsenious acid swallowed.) 
Ferri Phosphas. Dose, gr. v.-x. 
Ferri Pyrophosphas. Dose, gr. ij.-vj. 
Ferri Subcarbonas. Dose, gr. v.-xx. 
Emplastrum Ferri. 
Trochisci Ferri Subcarbonatis. 
Ferri Sulphas. Dose, gr. i.-v. 
Mistura Ferri Composita. Dose, f^ss. 



IRON 



207 



Ferri Sulphas Exsiccata. Dose, gr. i.-ij. 

Ferrum Redactum. Dose, gr. ij.-v. 

Pilula Ferri Carbonatis (Vallet's Mass). Dose, gr. 



x.-xx. 



Pilulae Ferri Compositse. Dose, 2 to 6 pills. 

Pilulae Ferri Iodidi (each contains gr. i. iodide of 
iron, and gr. J of reduced iron). 

Syrupus Ferri Iodidi (gr. vi].yi to f3j-)- Dose, nrxx. 
-xl. 

Liquor Ferri Nitratis. Dose, ni x.-xx. 

Liquor Ferri Subsulphatis (Monsel's Solution). Dose, 
irtij.-x. 

Liquor Ferri Tersulphatis (used to prepare hydrated 
sesquioxide). 

Potassii Ferrocyanidum. Dose, gr. x.-xv. 

Iron is also used in preparing Potassii Bromidum, Atn- 
monii Bromidum, and Ferri Bromidum (not officinal). 
Dose, gr. x.-xx.] 

Local Effects. 



Physiological. 

Certain of the stronger 
preparations of iron are very 
astringent, corrugating and 
hardening the tissues by co- 
agulating their albumen, and 
also contracting the smaller 
bloodvessels. 



Therapeutical. 

In the form of the per- 
chloride [chloride], iron is 
one of our most generally 
used astringents for the ar- 
rest of hemorrhage, as in 
epistaxis, leech - bites, in 
flooding (injected into the 
uterus, as advised by Dr. 
Barnes), or, in fact, in any 
variety of passive hemor- 
rhage. 

It is also a valuable appli- 
cation to relaxed mucous 
membranes ; thus, in many 
forms of sore throat, equal 
parts of tinct. ferri and gly- 
cerine will act well. It forms 
a good injection for leucor- 
rhoe.a, and is extensively em- 
ployed as an enema for the 
destruction of thread-worms. 



208 



IRON. 



Velpeau recommended the 
application of a strong solu- 
tion of sulphate of iron to 
the inflamed skin in erysipe- 
las, and Ricord considers 
that tartrate of iron has an 
almost specific influence over 
the destructive ulcerative 
process of syphilitic phage- 
dena . 



Internal Actions and Uses. 



. Physiological. 

i . Brain and Nervous Sys- 
tem. — Iron has a tonic in- 
fluence over the nervous 
system, but occasionally, in 
plethoric persons, the 
stronger preparations will 
cause an uncomfortable 
sensation of fulness and 
throbbing in the head. 



2. Circulation and Respi- 
ration. — Iron acts as a tonic 
to the muscular structures 
of the heart, probably by 
supplying the stimulus of a 
larger supply of healthy 
blood. It is well known 
that iron not only augments 
the quantity of red coloring 
matter in the red corpuscles 
of the blood, but actually 
increases their number, this 
fact being proved by an 
ingenious instrument which 
enables us to calculate the 
proportion of red corpuscles 



Therapeutical. 

i. Iron is much used as 
a tonic in all conditions of 
nervous exhaustion and de- 
bility. Thus in neuralgia, 
which consists in a weakened 
state of the roots of certain 
sensory nerves, it is invalu- 
able. In chorea, which 
generally coincides with de- 
bility, and in all cases 
depending in any way on 
want of nerve tone, it is a 
remedy of real value. 

2. This increase in the 
red corpuscles of the blood, 
and, as a consequence, in 
the extent to which these 
important bodies carry out 
their function of bearing 
oxygen to the tissues, and 
finally converting it into 
ozone, explains further the 
marvellous tonic influence 
of iron. In anaemia, in 
protracted convalescence 
from acute disease, in gene- 
ral feebleness or debility, 
in chlorosis where it also 
acts by giving increased 



IRON. 



209 



which any given quantity of 
blood contains. 



3 . On Secreting Organs. — 
On the stomach, iron acts 
by bracing up the raucous 
membrane, and improving 
the appetite and digestive 
tone. 

Its astringency tends to 
cause constipation. 



Urine. — Iron increases 
the amount of urea given off 
by the urine, and occasion- 
ally irritates the bladder, 
causing frequency of mictu- 
rition. 



tone to the uterine functions, 
in struma, rickets, secondary 
syphilis, &c, iron forms the 
basis of every method of 
treatment. 

3. Here we have another 
explanation of its tonic 
properties. 



This action is utilised in 
the treatment of diarrhoea, 
where some of the more 
astringent preparations, as 
the pernitrate [nitrate, U. 
S.], are often of service. 

[But in ordinary tonic 
doses, the tincture of the 
chloride relieves vesical 
irritability , strangury, and 
spasmodic stricture ; and is 
much used in gleet and 
chronic Bright 's disease. ] 



On Temperatu re. — I r o n 
raises the temperature partly 
by increasing the waste of 
the tissues, but partly also 
in virtue of its ozonising 
properties. 

Specific Action. 

Iron has a very marked influence in checking erysipelas, 
which must be called specific. We here use the tincture 
of the perchloride [chloride], and give it in doses of from 
fjss. to f5j- every three or four hours. It is also of ser- 
vice in diphtheria ; and Dr. Russell Reynolds has lately 
brought the evidence of over sixty cases to show that in 
acute rheumatism, given in large doses, it rapidly dimin- 
ishes the pain and fever. 

Mode of Absorption and Elimination. 

The more soluble forms of iron are readily absorbed, 

18* 



2IO IRON. 

and become combined as albuminates with the albumen of 
the blood, whilst the insoluble preparations must first 
undergo solution in the gastric juice. When they have 
played their part within the organism, they are thrown out 
principally by the fseces, to which they impart a blackish 
color, but also in some measure by the urine and by albumi- 
nous secretions such as those of the bile, and all mucous 
and serous membranes. 

Modes of Administration. Drawbacks. 

We have seen that various inconveniences may attend 
the use of iron, such as headache, irritability of bladder, 
constipation, nausea, &c, and it further has the disadvan- 
tage of blackening the tongue and teeth ; but many of 
these evils may be avoided by using the lighter or less 
astringent preparations, such as the citrate of quinine and 
iron, yinum, saccharated carbonate, by combining with 
some aperient, and by giving each dose after a meal. 

But if no contra-indication exists, there is no doubt that 
the astringent properties of the per-salts [sesqui-salts] 
stand us in good stead, and in particular, no preparation 
is so useful on the whole as the old muriated tincture. In 
secondary syphilis the syrup of the iodide is of service, and 
children will always take steel wine or the saccharated 
carbonate well ; whilst in cases of chlorosis with disorder- 
ed menstrual function we shall find the mist, ferri com- 
posita to be very efficacious in improving the quality of 
the blood and gently stimulating the uterus to resume its 
neglected duties. The sulphate of iron has some influ- 
ence in aiding the action of some purgative salts, as the 
sulphate of magnesia. The preparations of iron are so 
very numerous that no one but a student on the very brink 
of an examination would think of burdening his memory 
with them all ; and we shall only refer, therefore, to those 
which form part of the daily stock-in-trade of the practical 
physician. 

Vinum ferri [Br.] may be given in doses of from f 3j. 
to f 5ij. ; mistura ferri aromatica [Br.] f^j. ad f Jij. ; mis- 
tura ferri composita f|j. ad f^ij. ; ferri carbonas saccha- 
rata [Br.] gr. v. ad $j.; syrupus ferri iodidi n^x. ad f 3j- ', 
ferri et ammonias citras gr. v. ad x. ; ferri et quinise citras 
gr. v. ad xx. Or in combination : — 



FIG — MALE FERN. 211 

{£. Tincturse ferri perchloridi [chloridi] Tl\x. ; 
Spiritus chloroformi TT^xv. ; 

Glycerini f 5 SS - 5 

Infusi calumba? ad f ^j. M. 

Ter die sumend. 

Chalybeate mixture. 

R. Misturae ferri composite, 

Decocti aloes compositi [Br.] aa f§ss. M. 

Fiat haustus ter die sumendus. 

R. Magnesia; sulphatis §ij.; 

Ferri sulphatis gr. xxiv. ; 

Acidi sulphurici diluti f gij. ; 

Infusi calumbae ad f §viij. M. 

Fiat mistura. Capiat cochlearia duo magna omni mane. 

Ferruginous aperient. 

Iron, as a rule, is best taken after a meal, but we must 
warn our patient to avoid the neighborhood of tea, as the 
mixture of these two ingredients forms a species of ink 
which is both nauseous and unsightly. As the more as- 
tringent preparations not only stain but injure the teeth, 
they may be conveniently sucked through a glass tube. 



FICUS— FIG. 

\_The dried fruit of Ficus Carica, U.S.'] 

Figs are slightly laxative, [and enter into Confectio 
Sennse, U. S.] 



FILIX MAS— MALE FERN. 

[ The rhizome covered with portions of the stipes of Aspidium Filix mas. 
When used only such portion of the rhizome as has retained its green 
color should be employed, and the stipes, being inert, should be re- 
moved. U. S. 

Officinal Preparation, U. S. 
Oleoresina Filicis. Dose, rr^v.-xv.] 

Local Action. 
Fern oil has no local action. 

Constitutional Action. 

Physiological. Th erapeutical. 

The only marked action Fern-oil is used in medi- 
of the male fern is that of cine purely as an anthelmin- 



212 



FENNEL — GALEA NUM. 



killing tape-worms. It oc- 
casionally produces a little 
nausea and diarrhoea, but in 
most cases it can be taken 
without discomfort. [Its vir- 
tue resides in an oleoresin, 
which is the officinal title in 
the U. S. P., but which is 
termed a fluid extract in the 
Ph. Br. ; it is also sometimes 
spoken of simply as the oil 
of male fern.] 



tic. Its destructive influence 
over all varieties of toenice 
has been effectually proved 
by a great mass of evidence, 
and one or two doses gene- 
rally succeed in dislodging 
the entire worm. It is essen- 
tial that the draught should 
be taken on an empty sto- 
mach, and, the intestines 
having been first cleared by 
a purgative, we direct our 
patient to fast for a few hours 
before bed-time, when he is 
advised to take a drachm of 
the liquid extract [oleoresin] 
suspended in milk. Or we 
may avail ourselves of the 
following formula, which 
acts well in concealing the 
nauseous flavor of the drug : 

R. Extracti filicis liquidi [oleoresinse filicis] f.^jss. ; 
Mucilaginis tragacanthae f §ss. ; 

Syrupi zingiberis ^3U- '■> 

Aqnoe ad f| jss. 

Misce, fiat haustus nocte vel primo mane sumendus. 



[FCENICULUM— FENNEL. 

The fruit of Fceniculum dulce (De Candolle*), U. S. 

Officinal Preparations, U. S. 

Oleum Fceniculi. Dose, n^v.-xv. 
Tinctura Rhei et Sennae. Dose, f^ss.-ij. 
Aqua Fceniculi (oil ttlxv. to Oj.). 

Much used in infusion as an aromatic carminative, for 
flatulent colic in infants.] 



GALBANUM— GALBANUM. 

[The gum- resin of an undetermined plant, U. S. 

Dose, in substance, gr. x.-xx. 



NUTGALL. 213 

Officinal Preparations. 

Emplastrum Assafcetidae. 

Emplastrum Galbani Compositum (containing tur- 
pentine, Burgundy pitch, and lead plaster). 

Pilulae Galbani Compositse (each, galbanum, gr. jss.j 
myrrh, gr. jss.; assafcetida, gr. ss.).] 

Galbanum and ammoniacum are substances of no special 
theoretical value, [but are ranked as expectorants, anti- 
spasmodics, and stimulants.] 



GALLA— NUTGALL. 

[A morbid excrescence upon Quercus infectcria, U. S. 

Officinal Preparations, U. S. 

Acidum Gallicum. Dose, gr. v.-xx. 
Acidum Tannicum. Dose, gr. j.-iv. 
Tinctura Gallae ("3 Ij . to Oj.). Dose, f5j -f3iij- 
Unguenturn Galls (1 to 7 of lard). 
Unguentum Acidi Tannici (5ss. to gj.). 
Glyceritum Acidi Tannici (3ij- to f 3j.)« 
Glyceritum Acidi Gallici (5ij. to gj-)- 
Suppositoria Acidi Tannici, each gr. v. 
Trochisci Acidi Tannici, each i.] 

External Action. 

Physiological. Therapeutical. 

Tannic acid has a power- Tannic acid is a better 
ful local astringent action, topical astringent than gal- 
owing partly, no doubt, to lie, and may be used to arrest 
its power of coagulating al- hemorrhage, or diarrhoea, or 
bumen, and "tanning," in as an injection for gonorrhoea 
some degree, any part to and leucorrhcea. Combined 
which it may be applied. with glycerine, in the form 

•of the glycerite of tannin, 
it is very useful as an appli- 
cation in various forms of 
sore throat, and to arrest the 
discharge in some chronic 
affections of the os uteri, in 
the chronic-weeping stage 



214 GAMBOGE. 

of eczema, in ozcena, and 
chronic otorrhce.a. It may 
also soothe and restrain some 
of those irritable coughs 
which depend on chronic 
irritation about the pharynx. 
Galls are used, in the form 
of ointment, as an applica- 
tion to haemorrhoids. 

Internal Action. 

Tannic and gallic acids Tannic acid is rarely used 
are both powerful astrin- internally, but gallic acid is 
gents, but as tannic acid is serviceable in various forms 
rapidly converted in the of haemorrhage, such as hoz- 
system into gallic acid, it is mofttysis, hcematemesis, and 
preferable to use the latter. Menorrhagia; but in all of 
This conviction is proved these it must yield the palm 
by the fact that if we take to ergot, and it is more espe- 
the urine of a patient to cially in haemorrhage from 
whom tannic acid has been the kidney that its curative 
given, we find that it will not action comes into play. It 
precipitate gelatine, but that has also been used with suc- 
it strikes a blackish tint with cess to check the excretion 
the persalts of iron. of albumen in chronic renal 

disease. 
R. Acidi gallici 5J- '■> 

Glycerini f§ss. ; 

Aquae destillatse f§ v j- M. 

S. f§j. terdie. 

For haemorrhages. 



GAMBOGIA— GAMBOGE. 

[A gum-resin derived from Garcinia Morella (Desrozcsseaux), var. 
pedicellata, U. S. 

Dose, in substance, gr. ij.-iij. 
It enters into Pilulae Catharticae Compositae.] 

Local Action. 

Gamboge has no local action, and differs from some 
other remedies of the same class by not exerting its pur- 
gative effects when applied to a raw surface or injected 
into the cellular tissue. 



GAMBOGE 



215 



Constitutional Action. 



Th erapentical. 

Gamboge is a drastic, hy- 
dragogue cathartic, formerly 
much used where free purga- 
tion of watery fluid seemed 
to be indicated, as in cardiac 
dropsy ; but it is not only 
disagreeable and irritating, 
but uncertain, and has there- 
fore been in great measure 
superseded by other reme- 
dies on which more depend- 
ence can be placed. 



Physiological. 

On the Digestive and Se- 
creting Organs. — Gamboge 
exerts a good deal of irri- 
tating effect, acting more 
especially on the small intes- 
tine, and producing the dis- 
charge of large quantities of 
watery fluid. If given in 
sufficient quantity, inflam- 
mation and ulceration of the 
stomach and intestines may 
supervene, and death has 
followed the administration 
of a single drachm of the 
powder. It is also usually 
looked upon as a diuretic, 
but no trustworthy evidence 
has been given of its efficacy 
in this direction. 



Absorption, Mode of Elimination, &c. 

In order to insure its full absorption it seems necessary 
that gamboge must be previously dissolved in the bile, as 
we have seen that local application does not produce any 
purgative effect. It is, of course, thrown out in great 
measure by the intestines, but the coloring matter is ex- 
creted by the urine, to which it imparts a bright yellow 
tinge. 

Mode of Administration, Dose, &c. 

The great objection to the use of gamboge is its uncer- 
tainty, as we can never precisely foresee the cases in which 
it will cause troublesome vomiting and purging. To try 
and obviate this, therefore, as well as to conceal its acrid 
taste, we generally combine it with other drugs ; but on 
the whole I think I am justified in saying that gamboge 
has no therapeutic advantage which cannot be obtained 
more conveniently and agreeably by the use of other pur- 
gative drugs. 

We may most conveniently prescribe the compound pill, 



2l6 YELLOW JASMINE. 

which contains gamboge, aloes, cinnamon, hard soap, and 
syrup, and of which the dose is from 5 to 15 grains. 
[The compound cathartic pill U. S. P. contains calomel 
gr. j. ; jalap gr. j. ; compound extract of colocynth 
gr. )yi. ; and gamboge gr.^. Dose, 1 to 4 pills.] 



[GAULTHERIA— PARTRIDGE-BERRY. 

The leaves of Gaultheria procumbens, U. S. 

Officinal Preparations, U. S. 

Oleum Gaultheria, Syrupus Sarsaparillae Compositus, 
and Trochisci Morphise et Ipecacuanhas. 

Winter-green, or tea-berry, is an aromatic astringent 
tonic, but is chiefly used as a flavoring addition to mixtures.] 



GELSEMIUM— YELLOW JASMINE. 

[ The root of Gehemium sempervirens ( Gray's Manual of Botany} , U. S. 

Officinal Preparation, U. S. 

Extractum Gelsemii Fluidum. Dose, gtt. n^v.-x. 

The tincture is generally kept in the shops, but is not 
officinal. Dose, gtt. x.-xl.] 

Constitutional Action. 
Physiological. Therapeutical. 

1. Brain and Nervous 1. Gelsemium has been 
System. — Large doses of prescribed with success in 
gelsemium cause vertigo neuralgia of the fifth nerve, 
and double vision. A para- intercostal, and ovarian neu- 
lysing influence is exerted on ralgia, and myalgia. 
the spinal cord, the power 
of voluntary movement be- 
ing finally quite abolished, 
numbness and staggering 
being preliminary symp- 
toms. Reflex irritability is 
also suspended, the pupil di- 
lates, and at a later stage the 
sensory columns of the cord 
are also paralysed, produc- 
ing complete anaesthesia 
(Bartholow). 



GENTIAN. 



217 



Ringer tells us that large 
doses of the alkaloid [Gel- 
semia, of which gr. I has 
caused death], at first para- 
lyse, and then excite teta- 
nus, which in a short time 
gives way to paralysis. 

2. Heart and Circulation. 
— A slightly weakening effect 
on the heart is noted. [It 
diminishes the pulse-rate by 
lessening the irritability of 
the excito-motor ganglia of 
the heart, and the arterial 
pressure by diminishing car- 
diac irritability and vaso- 
motor tonus. 1 ] 

3. Respiration and Te7?i- 
perature. — The respirations 

become labored, shallow, 
and irregular, from dia- 
phragmatic paralysis, death 
ensuing from asphyxia. The 
temperature falls, probably 
in consequence of the pro- 
fuse perspiration which en- 
sues. 



It has been recommended 
as a remedy for tetanus. 



3. Bartholow recommends 
gelsemium in various forms 
of convulsive or spasmodic 
cough, and in acute inflam- 
mations of the lungs and 
pleura he thinks it may do 
good by diminishing the 
activity of the respiratory 
functions. 



Dose, &c. 

We may give from 20 to 30 minims of the tincture every 
three hours, until drooping of the eyelid, dilatation of the 
pupil, and muscular languor are noted. 



GENlTANA— GENTIAN. 

[ The root of Gentiana lutea, U. S. 

Officinal Preparations, U. S. 

Extractum Gentianae. Dose, gr. ij.-iv. 
Extractum Gentianae Fluidum. Dose, tt^x.-xxx. 
Infusum Gentianae Compositum. Dose, fsj.-ij. 
Tinctura Gentianae Composita. Dose, f 3j.-iv. 



1 [Dr. Ott, Phila. Med. Times, vol. v.] 



19 



2l8 CRANESBILL — GLYCERINE. 

Gentian is the type of the simple bitters, and is largely 
employed in cases where a tonic of this kind is indicated. 
As it contains no astringent element, it may readily be 
exhibited in combination with iron.] 

Gentian and chiretta may be grouped together, as their 
action is almost precisely similar. They are both light, 
agreeable tonics, with pleasant aromatic bitter flavor, 
and may be used freely in dyspepsia and debility with loss 
of appetite. Gentian has always, however, been much 
more generally employed than chiretta, and this may be 
partly due to the very agreeable compound preparations 
of the former drug. 



[GERANIUM— CRANESBILL. 

The rhizome of Geranium maculatum, U. S. 

Officinal Preparation, U. S. 

Extractum Geranii Fluidum. Dose, fjss.-j. 

Crowfoot, or cranesbill, is an indigenous astringent 
tonic, containing tannic and gallic acids, and may be used 
with advantage in bowel complaints, and as a styptic. A 
decoction in milk is sometimes given to children.] 



GLYCERINA— GLYCERINE. 

\_A color/ess, inodorous, syrupy liquid, of a sweet taste, and having 
the sp. grav. 1. 25, U. S. 

Used in preparing the officinal Extracta Fluida, and the 
glycerita.] 

This useful substance is almost exclusively used exter- 
ternally. It moistens and softens the skin, and both pre- 
vents and cures the painful and unsightly cracks known as 
" chaps" on the hands. It is a serviceable application, 
either alone or combined with other drugs, in various 
forms of skin disease. 

It may soothe an irritable cough by moistening the dry- 
ness of the throat, and it is stated to be the most efficient 
means at our command for the prevention of bedsores. 
In addition to this, it forms an excellent vehicle for the 
solution of various drugs, as seen in the five glycerites of 



LICORICE. 219 

the Pharmacopoeia, having this additional advantage, that 
its adhesive nature enables the active ingredient to remain 
longer than it otherwise would in contact with the affected 
surface. It is also a good solvent of the alkaloids, dis- 
solving them freely, and, being decidedly antiseptic, it is 
now used for the preservation of vaccine lymph. 

Internal Use. 

It was thought at one time that glycerine might prove 
an agreeable and efficient substitute for cod-liver oil ; but 
this has not been confirmed, and glycerine is now seldom 
used internally. 

[Glycerita. 

The officinal Glycerites are — 

Glyceritum x\cidi Carbolici Glyceritum Picis Liquidse 

" Acidi Gallici " Sodii Boratis. 

" Acidi Tannici 

Their uniform strength is 3lj- to the ounce, except gly- 
cerite of tar, which is 3ss. to fsj.] 



GLYCYRRHIZA— LICORICE. 

[ The root of Glycyrrhizce glabra, U. S. 

Enters into the manufacture of Decoctum Sarsaparillas 
Compositum, Extractum Glycyrrhizae, Extractum Sarsa- 
parillae Fluidum Compositum, Infusum Lini Compositum, 
Pilulae Hydrargyri, and Syrupus Sarsaparillae Compositus. 

Officinal Preparations, U. S. 

Extractum Glycyrrhizae Fluidum (for flavoring). 
Extractum Glycyrrhizae. Liquorice.] 

This is only used as a flavoring ingredient, and [enters 
into the Mistura Glycyrrhizae Composita, Pilulae Ferri 
Iodidi, Tinctura Aloes, Tinctura Rhei et Sennae, Trochisci 
Glycyrrhizae et Opii, and Trochisci Cubebae. 

Liquorice is an excellent demulcent, and in the form of 
decoction is used in catarrhal affections and diarrhoea. It 
is largely used as a flavoring ingredient, and is perhaps 
the best adjuvant to quinia, to disguise the bitter taste of 
that drug.] 



220 COTTON COLLODION. 

[GOSSYPII RADIOS CORTEX— BARK OF 
COTTON ROOT. 

The bark of Gossypiiim herbaceum, and of other species of 
Gossypuim, U. S. 

Officinal Preparation, U. S. 

Extractum Gossypii RadicisFluidum. Dose, f5ss.-j. 

This is an efficient oxytocic and emmenagogue, largely 
employed in the south, in the form of decoction (f^jv. to 
Oj.) as a parturifacient. A tincture is also used.] 

GOSSYPIUM— COTTON. 

\A filamentous substance separated from the seed of Gossypit/m 
herbacetim, and of other species of Gossypium, U. S. 

Officinal Preparations, U. S. 
Pyroxylon. Gun Cotton. 
Collodium. Pyroxylon dissolved in ether and alcohol.] 

This useful substance is employed in various inflamma- 
tory conditions, with the view of excluding air and sup- 
plying warmth and slight support. Thus in burns, and 
more especially in those of a superficial nature, the imme- 
diate application of a thick layer of cotton-wool relieves 
the smarting pain and promotes recovery ; and the same 
treatment may be recommended to a blister after the watery 
fluid has been removed from the bulla. In acute rheuma- 
tisni, also, the patient may derive much relief from the 
careful and equable encircling of his inflamed joints with 
cotton-wool, secured in position by a few turns of flannel 
bandage. 

It is also believed by some aurists to form the best mate- 
rial for the construction of an artificial membrana tympani. 



[COLLODIUM— COLLODION. 

Collodium cum Cantharide. Blistering Collodion. 
Collodium Flexile. Flexible Collodion.] 

Collodion is used to fulfil two indications: — 
i. To exclude the action i. For this purpose it is 
of the air from inflamed parts, used to paint over the pus- 
and to prevent the patient tules of smallpox, in the hope 
from scratching and irritat- of preventing pitting. Also, 
ing the surface. in herpes zoster and in ery- 

sipelas it may be applied 
with advantage. 



GUAIAC. 221 

2. To exert a moderately 2. Dr. Hare tells us that, 
astringent effect from the at the very early or papular 
contraction which follows stage of a boil, we may avert 
its drying. subsequent suppuration by 

the application of collodion. 
Sir D. Corngan recom- 
mends sealing up the ex- 
tremity of the prepuce by 
collodion to remedy the 
nocturnal form of inconti- 
nence of urine in children, 
and it may be of service in 
haemorrhage depending on 
capillary oozing, and more 
especially in the troublesome 
bleeding frequently follow- 
ing leech-bites. 

Finally, its application 
may facilitate the healing 
process in small cuts and 
wounds, as after the ope- 
ration for harelip, and in 
the troublesome condition 
known as cracked nipples. 
Under all these conditions 
the best results may be ob- 
tained by using the flexile 
collodion, in which the com- 
bination with castor-oil pre- 
vents the too rapid cracking 
or peeling away of the pro- 
tecting film. 



[GUAIACUM— GUAIAC. 

The heart-wood of Guaiacum officinale, U. S. 

Guaiaci Lignum. 

Guaiaci Resinse. A peculiar resin obtained from 
Guaiacum officinale, by spontaneous exudation, by incision, 
by dry heat, or by decoction of the comminuted wood, U. S. 

19* 



222 GUTTA-PERCHA — LOGWOOD. 

Officinal Preparations, U. S. 

Tinctura Guaiaci. Dose, f 3j.-ij. 

Tinctura Guaiaci Ammoniata. Dose, f 3j.-ij. 

Also enters into Decoctum Sarsaparillae Compositum, 
Syrupus Sarsaparillae Compositus, and Pilulae Antimonii 
Composite. 

Uses. 

Guaiac is alterative, and is largely employed in chronic 
rheumatism, rheumatoid arthritis, and syphilis. The ammo- 
niated tincture is the best preparation, and should be given 
in milk.] 



GUTTA-PERCHA— GUTTA-PERCHA. 

\_Thc concrete juice of Isonandra gutta {Hooker. Loudon's Journal 
of Botany, 1848), U. S. 

Officinal Preparation, U. S. 

Liquor Gutta-Perchse (in chloroform). Used in 
making charta sinapis.] 

Gutta-percha is only adapted for external use, and is of 
service mechanically as a material for splints, being readily 
softened in hot water and moulded to the affected joint or 
limb. It furnishes a cheap and efficient rival to oiled silk, 
and its solution in chloroform forms a good and impervi- 
ous covering in smallpox, erysipelas, and other affections 
where it is of importance to protect the skin from the 
action of the air. 



H^EMATOXYLON— LOGWOOD. 

\The heart-wood of Hcematoxylon Campechianum, U. S. 

Officinal Preparations, U. S. 

Decoctum Haematoxyli. Dose,, f^ij. 
Extractum Hsematoxyli. Dose, gr. x.] 

Logwood has astringent It is an agreeable and 

properties. efficient remedy in diarrhoea, 

[It may be combined for and is well taken by chil- 

children as in the following dren. We must remember 

formulae : — ] that it imparts its pink color 

to the faeces, and to the urine 
should that secretion chance 
to be alkaline. 



AMERICAN PENNYROYAL BARLEY. 22 J 

I£. Extracti haematoxyli gr. x. ; 

Tincturse catechu f ^ss. ; 

Syrupi f&j. ; 

Aquae carui ad f §ss. M. 
Ter die. 

IJ. Pulveris cretae aromatici [Br.] 5i- '■> 
Tincturae opii f 3j- \ 

Syrupi zingiberis f ^j. ; 

Decocti haematoxyli ad f §vj. M. 

Fiat mistura, cujus sumat unciam imam post singulas 
dejectiones liquidas. 



[HE DEOMA— AMERICAN PENNYROYAL. 

The leaves and tops of Hedeoma Pidegioides, U. S. 

Officinal Preparation. 
Oleum Hedeoma. Dose, gtt. ij.-x. 

Hedeoma is a gentle stimulant aromatic used in flatu- 
lent colic, sick stomach, and in amenorrhea. In recent 
suppression of the menses, it is a popular domestic remedy, 
given in warm infusion.] 



[HELLEBORUS— BLACK HELLEBORE. 

Root of Helleborus niger, U. S. 

(The dose of the powdered root is gr. ij.-iij., as an 
alterative; or gr. x.-xx. as a purge.) 

Officinal Preparations, U. S. 

Extractum Hellebori. Dose, as a purgative, gr. x. 
Tinctura Hellebori. Dose, as a purgative, f3ij- 

Chiefly interesting on account of its popularity among 
the ancients as a hydragogue cathartic, but as it is harsh 
and uncertain in its action, it is rarely, if ever, used at 

present.] 

HORDEUM— BARLEY. 

[ The decorticated seed of Hordeum distichon, U. S. 

Officinal Preparation, U. S. 

Decoctum Hordei (%). to Oj.) ad lib. "\ 

In the form of decoction, barley is used as a demulcent 
drink. [Malt extract is largely used as nourishment, given 
preferably in milk.] 



224 HOPS — MERCURY. 

HUMULUS— HOPS. 

[ The strobiles of Hunmlus lupuhis, U. S. 

Lupulina. The yellow powder separated from the stro- 
biles of Humulus lupuhis, U. S. 

Officinal Preparations, U. S. 

Infusum Humuli (]§ss. to Oj.). Dose, ad lib. 

Tinctura Humuli (Hijss. to Oj.). Dose, f^ss.-ij. 

Extractum Lupulinae Fluidum (£xvj. toOj.). Dose, 
f5ss.-ij. 

Oleoresinae Lupulinae. Dose, nrx-f5j. 

Tinctura Lupulinae (Jij. to Oj.). Dose, fgss.-ij.] 

Hops are tonic and probably narcotic, more especially 
in the form of the old-fashioned hop-pillow. Internally 
they are rarely prescribed. [They are much used as an 
anodyne cataplasm, either alone or with Indian meal. 
The preparations of lupulin are sometimes administered 
in delirium tremens as a sedative tonic] 



HYDRARGYRUM— MERCURY. 

\_A silver-white metal, liquid at common temperatures, and having the 
sp. grav. 13.5, U. S. 

Officinal Preparations, U. S. 

I. In the Metallic State. 

Hydrargyrum. 

Emplastrum Ammoniaci cum Hydrargyri. 

Emplastrum Hydrargyri. 

Hydrargyrum cum Creta (mercury 37^ per cent."), 

gr. v-xxx. 
Pilulse Hydrargyri (mercury 2>zV^> P er c -)> 3 S r - pills. 
Unguentum Hydrargyri (mercury 50 per cent.). 

II. Oxidized. 

Hydrargyri Oxidum Rubrum. Used externally. 

Unguentum Hydrarg. Oxidi Rubri (5j--3vij.)« 
Hydrargyri Oxidum Flavum. Used externally. 

Unguentum Hydrarg. Oxidi Flavi (3j- - 3vij.). 

III. Sulphuretted. 

Hydrargyri Sulphuretum Rubrum. For fumigating. 

IV. As Protochloride (subchloride?). 

Hydrargyri Chloridum Mite. Dose, gr. ss.-x. 



MERCURY. 225 

Pilulge Antimonii Compositse (calomel 16^3 perct.). 
Pilulae Cathartica Compositse (each pill contains, 

calomel, ext. jalap, aagr. j.; ext. colocynth. comp. 

gr. j.ji; and gamboge, gr. }(). Dose, 1 to 4. 

V. As Bichloride (proto-chloride ?, perchloride, Br.). 

Hydrargyri Chloridum Corrosivum, gr. t V~"to- 
Hydrargyrum Ammoniatum. Used externally. 
Unguentum Hydrarg. Ammoniati (gr. xl.-^j.). 

VI. With Iodine. 

Hydrargyri lodidum Rubrum (biniodide), gr. T ^-. 
Unguentum Hydrargyri Iodidi Rubri (gr. xvj. to 

Sj-)- 

Liquor Arsenici et Hydrargyri Iodidi (Donovan's 

Solution). Dose, r^v.-x. 
Hydrargyri lodidum Viride (protiodide). Dose, gr. j£. 

VII. With Cyanogen. 

Hydrargyri Cyanidum. Dose, gr. T V~/^« 

VIII. With Acids. 

Liquor Hydrargyri Nitratis. As a caustic. 

Unguentum Hydrargyri Nitratis (Citrine ointment). 
Hydrargyri Sulphas Flava. Dose,gr. %-}4 (Turpeth 

Mineral). As an emetic, gr. ij. 

Antidotes. 

Acute poisoning produced by corrosive sublimate re- 
quires albumen (white of eggs, blood, or flour and water) 
and demulcents. Milk may be freely drunk, and vomit- 
ing encouraged. Gold leaf and iron-filings form a chemi- 
cal antidote, decomposing the chloride and depositing the 
mercury.] 

Local Actions. 

Physiological. Th erapeutical. 

One preparation, the acid The acid nitrate is used 

nitrate, is a very powerful as an application in lupoid 

caustic. ulcerations, and in ulcera- 

Other preparations are tions about the os and cervix 

occasionally used externally uteri. 

for skin diseases, syphilitic Calomel dissolved in lime- 

ulcerations, &c, and in vir- water [3j. to Oj.], and 

tue of the destructive power forming the familiar black- 



226 



MERCURY. 



which they all (but more 
especially corrosive subli- 
mate) exert over the lowest 
forms of animal and vege- 
table life. Mercury, being 
readily absorbed by the 
skin, is frequently introduced 
into the system by this 
channel. 



wash, is of great service in 
venereal ulcerations, either 
primary or secondary ; and 
the same salt, in the form 
of powder, may be dusted 
on condylomata or corneal 
ulcerations with advantage. 
Corrosive sublimate, in the 
form of lotion, often checks 
troublesome ulcerations of 
the throat j and both this 
and the various forms of 
mercurial ointment are 
almost infallible remedies 
for pediculi or for favus, 
tinea tonsurans, and other 
skin diseases which are 
known to depend on the 
presence of minute vegeta- 
ble growths. We must 
remember, however, that 
dangerous symptoms, and 
even death, have occasion- 
ally been caused by the 
absorption of the mineral 
when thus applied. 

Many chronic skin dis- 
eases may be well treated 
by citrine ointment. Goitre 
frequently yields in India to 
the inunction of the binio- 
dide, and Mr. Marshall has 
highly recommended the 
oleate of mercury as an 
application to various joint 
affections. 

The external application 
of mercury, by the calomel 
vapor bath, or blue ointment, 
having for its object the 
production of constitutional 
effects, will be considered 
further on. 



MERCURY. 



227 



Internal Actions and Uses. 



1. Brain and Nervous 
System. — Mercury, pushed 
up to the development of 
poisonous symptoms, pro- 
duces a curious condition of 
nervous debility and tre- 
mors, which is occasionally 
met with in workmen who 
have been freely exposed to 
its fumes in silvering glass. 

2. Circulation and Respi- 
ration. — One form of mer- 
cury, the perchloride, or 
corrosive sublimate, acts as 
a cardiac poison, distinctly 
lowering the action of the 
heart, but the other prepa- 
rations have no such influ- 
ence. Mercury causes anae- 
mia by destroying the red 
corpuscles of the blood. 
[But in minute doses, gr. t Jq 
to T -Jo, given thrice daily for 
a length of time, corrosive 
sublimate acts as a tonic and 
increases the number of the 
red-blood corpuscles, par- 
ticularly in syphilitic anoz- 
mia.~\ 

3. Secreting Organs — Sto- 
mach and Intestines. — Mer - 
curial preparations, and 
more especilly calomel, act 
as purgatives, causing re- 
peated grayish or greenish 
evacuations; the duodenum 
being the portion of the gut 
primarily acted upon. The 
action of mercury on the 
liver has provoked a good 
deal of controversy; and, 



1. Mercury has been 
found of most signal service 
in some forms of advanced 
syphilitic disease affecting 
the brain. 



3. In that form of vomiting 
common in children, where 
the stomach rejects every- 
thing suddenly and violent- 
ly, 3/3 gr. of hyd. cum cret& 
or Ye gr. of calomel every 
hour will often cure, as 
Ringer has shown. 

Calomel and blue pill are 
frequently used as adjuncts 
of other purgative drugs. 

Clinical evidence has most 



228 



MERCURY. 



whereas it was formerly held 
that the biliary secretion was 
directly stimulated, the ex- 
periments of Bennett and the 
Edinburgh Committee seem 
to show that, on the con- 
trary, the flow of bile is 
actually checked or dimin- 
ished by calomel. Two ob- 
vious fallacies underlie these 
experiments — the first being 
that the dogs, kept for con- 
siderable periods with bili- 
ary fistula, were so affected 
not only by the shock of the 
operation, but by the result- 
ing inconvenience, general 
discomfort, and gradual 
starvation, that secretion 
must of necessity have been 
in great measure suspended ; 
and, secondly, it is well 
known that a remedy which 
has no effect on a healthy 
organ may powerfully mod- 
ify its condition when in a 
state of congestion or func- 
tional derangement. 

Kidneys. — Mercury, and 
more especially blue pill, 
has the power of promoting 
the action of diuretics. 

Saliva. — Mercury is well 
known to stimulate the ac- 
tion of the salivary glands, 
large quantities of their 
secretion being poured out 
when the drug is pushed far 
enough. The fluid, at first 
thick and containing much 
albumen, subsequently be- 
comes thin and watery. 



distinctly proved, not only 
that the well-known symp- 
toms of biliousness may be 
most effectually removed by 
the old-fashioned blue pill 
and black draught, but that 
an increase of bile may also 
be thus produced in the mo- 
tions. This has been ex- 
plained by the irritating in- 
fluence of the mercury on 
the duodenum, and the con- 
sequent sweeping away of 
the secreted bile, which, un- 
der ordinary circumstances, 
is well known to undergo 
reabsorption from the intes- 
tines. 

Mercury has been sup- 
posed also to act by stimu- 
lating the gall-bladder to 
contract. 



Thus, in the form of the 
old pill, containing blue pill, 
squill, and digitalis, we ob- 
tain a most marked diuretic 
effect. 

The old-fashioned notion 
is now happily exploded, 
that we must measure the 
efficacy of our mercurial 
treatment by the amount of 
salivation. 



MERCURY. 229 

Skin. — Inunction of ung. 
hydrargyri is apt to bring 
out a crop of irritable pim- 
ples, and one of the symp- 
toms of mercurial poisoning 
is an eczematous eruption. 

Mercury is supposed to Mercury was accordingly 
stimulate absorption by invariably given, in former 
rendering effused fibrine less days, in all cases where any 
cohesive, by promoting its effusion of fibrine was sup- 
disintegration, and by re- posed to have taken place, 
tarding cell-growth. such as the second stage of 

pneumonia. 

Specific Action. 

Mercury may be said to act as a specific in syphilis, and 
more especially in the primary and secondary stages of 
that insidious malady. When we are satisfied that we 
have to deal with an infecting sore, the sooner we begin 
our mercurial treatment the better ; and it is well to push 
it in small doses for a considerable time, until the gums 
are slightly affected. For this purpose moderate doses of 
blue pill and opium are perhaps the most effectual ; but 
we may also derive much benefit now and then from rub- 
bing in 5ss. to 3j- of blue ointment night and morning. 
The whole train, also, of seondary eruptions of the skin, 
sore throat, condylomata, iritis, &c, must also be subjected 
to mercurial treatment, and the calomel vapor bath and 
the bichloride of mercury will here do us good service. 

It is doubtful whether, by the most careful and scientific 
treatment of a primary sore, we can altogether prevent 
the development of secondary symptoms ; but if we can- 
not do this we can at least postpone them, and render 
them less severe. 

In the congenital syphilis of young children, the local ap- 
plication of a little blue ointment, either rubbed into the 
skin or smeared over a bit of flannel wound round the 
waist, is eminently satisfactory in its results. 

Mercury was formerly believed to have a specific influ- 
ence in checking the inflammations of serous membranes, 
and was consequently invariably used in peritonitis, peri- 
carditis, and pleurisy ; but faith in this conviction has 
been a good deal shaken of late, and the conventional 
20 



230 MERCURY. 

calomel and opium does not so often appear in prescrip- 
tions as formerly. 

On the continent much importance is attached to con- 
siderable doses of calomel in the early stages of typhoid 
fever, but statistics do not seem to prove any decided 
advantage as accruing from this mode of treatment. 

Drawbacks, Mode of Administration, &c. 

It is important to be familiar with the signs which indi- 
cate when the mercurial treatment has been carried far 
enough. The gums generally give the first token in a 
delicate red line running along their margin, followed by 
pulpy thickening of the interdental portions, and finally 
retraction from the teeth. To this succeed [a coppery 
taste in the mouth], an increased flow of saliva and a 
peculiar fcetor of breath, and we generally find that the 
very slightest 'touching' of the gums is sufficient to show 
that the physiological effect of the mineral has been attained. 

Whilst a patient is undergoing a mercurial course, we 
must keep up his constitution well with good diet, iron, 
and perhaps a little stimulant ; for experience shows that 
mercury far more speedily exerts its debilitating influence 
on weak persons or those who are enfeebled by fasting. 

We must therefore beware Of its use in consumptive or 
strumous persons, or in those who are suffering from 
Bright's disease or diabetes, and recollect that idiosyncra- 
sy may here play an important part, and that some persons 
are much more readily salivated than others, without 
known cause. 

Children, more especially those under the age of two 
years, are rarely if ever salivated, and only show the influ- 
ence of the drug by peculiar greenish stools ; but we must 
beware of using it in them too freely, as Mr. Hutchinson 
has traced a peculiar malformation of the teeth to the 
incautious use of grey and other so-called ' teething' pow- 
ders in early life. [But where salivation does occur in 
children it is apt to be uncontrollable, and to be followed 
by destructive ulceration, or gangrene of the mouth and 
lips with ugly cicatrices.] 

Mode of Elimination, &c. 
Mercury is eliminated principally by the urine, but also 
in smaller degree by the saliva and the biliary and intes- 
tinal secretions. 



mercury. 23i 

Mode of Administration, Dose, &c. 

In the treatment of syphilis, mercury may be given by 
inunction, in which from 3 SS - to Jj. of blue ointment is 
rubbed into the skin once or twice a day, varying the 
place of application so as to avoid that cutaneous irritation 
which may otherwise result. This method, although very 
effectual, is dirty, and rather liable to cause excessive 
salivation. 

Fumigation is also extensively employed, but it is only 
of real service in the cutaneous affections dependent on 
secondary syphilis, where the actual deposition of the 
vaporised calomel on the skin produces a beneficial local 
influence. Twenty grains of calomel are used at each 
sitting, and are diffused along with watery vapor by a 
spirit lamp, and brought in contact with the patient, as he 
sits covered with a blanket, on a perforated chair, over 
the fumigating apparatus. 

Corrosive sublimate has been used by subcutaneous 
injection, but in this way it creates great local irritation, 
and is much better given by the mouth, acting especially 
well in secondary syphilis, combined with iodide of potas- 
sium. Thus : — 

R. Hydrarg. perchlor. [chlor. corrosiv. ] gr. ss. ; 
Potassii iodidi H ss -» 

Decocti cinchonse f ^viij . M. 

S. f§j. ter die post cibum. 

R. Hydrarg. perchlor. [chlor. corrosiv.] gr. ij. ; 
Acidi hydrochlorici diluti f £ij. ; 

Mellis depurati f §j. ; 

Aquoe destillatoe ad f ^x. M. 

An excellent gargle for syphilitic throat ulceration. 

Opinions vary considerably regarding the best form of 
mercury for internal administration in the treatment of 
syphilis. Mr. Hutchinson prefers hydrarg. cum creta in 
doses of from gr. iij. to gr. v. two or three times a day. 
Ricord, on the other hand, advises gr. j.-iij. of the green 
iodide, whilst others are content to employ the pil. hydrarg. 
in gr. j.-iij. doses in pill, keeping its purgative properties 
in check by a little opium. 

R. Pil. hydrargyri gr. ij. ; 

Pulveris opii gr. j^ ; 

Confectionis rosas q. s. 

Ut fiat pilula quarta quaque hora sumenda. 



232 MERCURY. 

B.. Hydrarg. subchlor. [chlor. mitis] gr. xij. ; 

Mannse gr. vj. ; 

Pulveris tragacanthse compositce [Br.] gr. vj. M. 
Divide in pilulas sex. Capiat duas pro re nata. 

A good purgative formula. 

For purgative purposes the blue pill is generally pre- 
scribed in 5 grain doses, taken overnight, and aided by 
some fluid aperient in the morning. As a diuretic the 
following is the useful old combination, sometimes known 
as the ' Guys,' and sometimes as 'Baillie's Pill : ' — 

R. Pilulas hydrargyri gr. iij. ; 

Pulveris scilla? gr. jss. ; 

Pulveris digitalis gr. ss. M. 
Fiat pilula bis terve die sumenda. 

[Unguentum hydrargyri nitratis, citrine ointment, is 
much used as a stimulant and alterative application in chro- 
nic skin-diseases and ophthalmia. It generally requires 
to be diluted with lard. 

The decoction of Zittmann may be used with great ad- 
vantage as a gentle diaphoretic and alterative in secondary 
syphilis, either alone or as an adjuvant to mercurials. It 
has been also used with advantage in scrofulous conditions 
of the system, in chronic rheumatism, in skin-diseases, 
and obstinate ulcerative affections. The formula of the 
Prussian Pharmacopoeia is as follows : — 

Take of sarsaparilla 12 ounces, spring water 90 pounds. 
Digest for twenty-four hours ; then introduce, enclosed in 
a small bag, l 1 /^ ounces of sugar of alum (equal parts 
alum and white sugar), T / 2 ounce of calomel, and a drachm 
of cinnabar. Boil to thirty pounds, and near the end of 
the boiling add aniseed, fennel-seed, of each half an ounce, 
senna 3 ounces, and liquorice root 1^ ounces. Put aside 
the liquor under the name of The Strong Decoction. 
To the residue add 6 ounces of sarsaparilla and 90 pounds 
of water. Boil to 30 pounds, and near the end add 
lemon-peel, cinnamon, cardamom, liquorice, of each 3 
drachms. Strain, and set aside, the liquor under the name 
of The Weak Decoction. Mercury was detected by 
Wiggers in this decoction in very small proportion. It 
should not be prepared in metallic vessels lest the mer- 
curial in solution should be decomposed. The decoction 
may be drunk freely. — U. S. Dispensatory, 14 ed. } Phila. 
1877, p. 1 1 40, note.'} 



HYDRASTIS — HENBANE. 233 

[HYDRASTIS— HYDRASTIS. 

The root of Hydrastis Canadensis, U. S. 

Officinal Preparation, U. S. 
Extractum Hydrastis Fluidum. Dose, f3ij.-iv. 

Hydrastis is an indigenous bitter tonic, containing the 
alkaloids berberina and hydrastia, and is said to have de- 
cided diuretic properties. A decoction has been used as 
an injection in gonorrhoea. Its exact therapeutic place 
among remedies does not appear to be well defined.] 



HYOSCYAMUS— HENBANE. 

[Hyoscyami Folia. The leaves of Hyoscyamus niger, 
U. S. 

Hyoscyami Semen. The seed of Hyoscyamus niger, 
U. S. 

Officinal Preparations, U. S. 

Extractum Hyoscyami (from the juice). Dose, gr. 
i.-iij. 

Extractum Hyoscyami Alcoholicum (dried leaves). 
Dose, gr. i.-iij.] 

Extractum Hyoscyami Fluidum (leaves). Dose, n^v. 

Tinctura Hyoscyami (dried leaves, Jij. to Oj.). 
Dose, fjss.-ij. 

Hyoscyamus is, like belladonna, a liypnotic and mydri- 
atic, and owns the same antidotes.] 

The remarks made with reference to stramonium are 
equally applicable to hyoscyamus, which also contains an 
alkaloid, hyoscyamia, probably identical with atropia. 
The main point of difference, then, from belladonna, is 
the superior narcotic powers of hyoscyamus, which have 
been especially prized and developed in lunacy practice. 
It is also a favorite remedy in painful and irritable affections 
of the bladder, where it seems to exert a marked soothing 
influence, and, as an expectorant, it is an excellent addition 
to cough mixtures. 

R. Extracti belladonnse gr. iij. ; 

Camphorse gr. xij.; 

Extracti hyoscyami gr. xv. 

Misce, fiant pilulae sex, quarum sumat unam hora decu- 
bitus. 
Narcotic. 

20* 



234 ISINGLASS — IGNATIA. 

&. Tincturse hyoscyami TTixxx. ; 

Potassii carbonatis gr. x. ; 

Syrupi papaveris [Br.] f 5'i- ; 

Aquae camphorce ad f^jss. 

Misce, fiat haustus hora somni sumendus. 
Narcotic. 

R. Vini ipecacuanhas f 5ij. ; 
Succi hyoscyami [ext. hyoscyami fluid.] f3J. ; 

Tincturse scillse f §ss. ; 

Syrupi tolutani f§j. ; 

Aquae carui ad f^vj. 

Misce. Cap. semunciam ter quaterve in die. 
Cough mixture. 

Dr. Robert Lawson, late of the West Riding Asylum, 
has recently made a large variety of very interesting phy- 
siological and therapeutical observations on the actions and 
uses of hyoscyamia, the alkaloid of hyoscyamus. He has 
found that it produces "a. subdued form of mania, accom- 
panied by almost complete paralysis of the voluntary mus- 
cles, and ending in quiet and refreshing sleep;" and he 
thinks that this might advantageously be substituted for 
many forms of extreme excitement occurring among the 
insane. He has derived great benefit from the drug in 
"the treatment of recurrent, acute, and subacute mania, 
and the monomania of suspicion," and recommends the 
following formula: — 

R. Hyoscyamiae gr. j. ; 

Sp. aetheris Triviij.; 

Alcohol TTi xxiv. ; 

Aquas fontis ad f Sjj. 

Misce, ut fiat haustus. 



[ICHTHYOCOLLA— ISINGLASS. 

The swimming-bladder of Acifiencer Huso, and of other fishes, U. S. 

Isinglass is only used in medicine as an article of diet 
for the sick, and as the basis of court-plaster. ~\ 



[IGNATIA— IGNATIA. 

The seed of Strychnos Ignatia, U. S. 

Officinal Preparation, U. S. 



i/_i/ 



Extractum Ignatia. Dose, gr. y± 

Is used for the same purpose as Nux Vomica, but the 
extract, containing more strychnia, is a somewhat stronger 
preparation.] 



INFUSIONS IODINE. 235 

[Infusa. 

The officinal Infusions are: — 

Infusum Angusturas Infusum Lini Compositum 

" Anthemidis " Pareiras 

" Buchu " Picis Liquidas 

" Calumbas " Pruni Virginianas 

" Capsici " Quassias 

" Caryophylli " Rhei 

" Cascarillas " Rosas Compositum 

" Catechu Compositum " Salvias 

" Cinchonas Flavas " Sennas 

" Cinchonas Rubrae " Serpentarias 

" Digitalis " Spigelias 

" Eupatorii ' ; Tabaci 

" Gentianas Compositum " Taraxaci 

" Humuli " Valerianae 

" Juniperi " Zingiberis.] 

" Kramerias 



IODINIUM— IODINE. 

\_A bluish gray non-metallic element obtained principally from the ashes 
of sea-zveeds. It rises in purple vapor when heated. 

Officinal Preparations, U. S. 

Tinctura Iodinii (iodine 3j. to Oj.). For external use. 

Tinctura Iodinii Composita (iodine ^ss. ; potass, iod. 
Jj.; alcohol Oj.). Dose, gtt. x.-xx. 

Liquor Iodinii Compositus (iodine 3vj.; potass, iod. 
^jss. ; water Oj.). Dose, gr. v.-x. 

Unguentum Iodinii. 

Unguentum Iodinii Compositum. 

Liquor Arsenici et Hydrargyri Iodidi (Donovan's 
Solution). Dose, gtt. v.-x. 

Syrupus Ferri Iodidi (iodide of iron, 7^ gr. to f5j.)- 
Dose, n^x.-xxx. 

Pilulse Ferri Iodidi (ferri iodid. gr. j.; ferri redact. J). 

Also enters into Sulphurislodidum, Unguentum Sulphuris 
Iodidi, Arsenici Iodidum, Hydrargyri Iodidum Rubrum, 
Unguentum Hydrargyri Iodidi Rubri, Hydrargyri Iodidum 
Viride, Plumbi Iodidum, Potassii Iodidum, and Unguent- 
um Potassii Iodidi. 

Antidotes. 

Starch and demulcents. 



236 



IODINE 



Incompatibles. 

With Iodine. — Alkalies and alkaloids (quinia and strych- 
nia); extracts containing starch; water precipitates the 
iodine from tinctura iodinii. The compound tincture may 
be diluted with water without precipitation. 

With Potassii Iodidum. — Acids, acetate of lead, and the 
metallic salts generally. 

With Ferri Iodidum. — Lime-water, alkalies, and the 
vegetable astringents.] 

Local Actions. 



Physiological. 

Iodine in substance is 
never used save for its anti- 
septic properties. Dissolved 
in spirit, however, it is an 
excellent counter-irritant, 
producing itching and smart- 
ing of the skin, with desqua- 
mation of cuticle, and even 
blistering if the application 
be too frequently repeated. 
It has been shown that this 
local action of iodine is at- 
tended by a very free extru- 
sion of colorless blood cor- 
puscles into the subcutaneous 
cellular tissue. 

Experiment has proved 
that iodine is not absorbed 
into the system through the 
unbroken cuticle. [But fatal 
poisoning has resulted from 
absorption of a solution of 
iodine, which had been in- 
jected into an ovarian cyst. 

Iodine and the soluble 
iodides are incompatible 
with the alkaloids as well as 
with most metallic salts in 
solution.] 



Therapeutical. 

It is therefore of some- 
value for the correction of 
foetor in drains, &c. 

The tincture or liniment 
of iodine is very extensively 
used as a counter-irritant 
application to enlarged 
glands, chronic abscesses, 
swollen joints, chilblains, 
and to various forms of skin 
disease, more especially the 
common varieties of ring- 
worm, which speedily yield 
to this treatment. It is very 
useful when painted over the 
chest in chronic pneumonia 
and fibroid and tubercular 
affections of the lungs; and 
Mr. Jordan, of Birmingham, 
has recently drawn attention 
to the great success attained 
by him in the dispersion of 
boils, carbuncles, and suppu- 
rating glands by iodine 
freely applied to a neighbor- 
ing vascular area. 

It is also an excellent in- 
jection into various secreting 
cavities, curing hydrocele by 
obliterating the sac of the 



IODOFORM IPECACUANHA. 237 

tunica vaginalis, acting well 
on the same principle in some 
rare cases of ovarian d?'opsy 
and bronchocele, and deo- 
dorising and lessening dis- 
charges in empyema and 
suppurating glands. [In 
scrofula Lugol's solution 
may be injected directly into 
the enlarged glands, with 
great benefit.] 
[For the Constitutional Effects, see Iodide of Potas- 
sium.] 

[IODOFORMUM— IODOFORM. 

In yellow, scaly crystals having the odor of saffron. It is insoluble in 
water, but soluble in alcohol, ether, and the fixed and volatile oils. 
By a heat above 2500^ it is decomposed, giving off violet vapors. U. S. 

It is prepared by decomposing an alcoholic solution of 
iodide of potassium with lime. As a local anaesthetic, it 
is applied in powder to painful ulcers, whether chronic, 
cancerous, or syphilitic, where it relieves pain and pro- 
motes cicatrization. Suppositories (gr. v.-x.) are used in 
hcemorrhoids and uterine cancer. In ethereal solution (20 
per cent.), it has been highly recommended as an applica- 
tion in chronic i?ifiammation of the throat. x ~\ 



IPECACUANHA— IPECACUANHA. 

[ The root of Cephcelis Ipecacuanha, U. S. 

Officinal Preparations, U. S. 

Extractum Ipecacuanhse Fluidum. Dose, gtt. xxx. 

Pulvis Ipecacuanhas Compositus. Dose, gr. x. 
Dover's powder (ipecac. 1 pt., opium 1 pt., carb. potass. 
8 pts.)- 

Trochisci Ipecacuanhas. 

Trochisci Morphise et Ipecacuanhas (Morphia gr. ^ ). 

Syrupus Ipecacuanhas (f^ij. extract to syrup xxx.). 
Dose, f 3J-— f ^ss. 

Vinum Ipecacuanhas (f^ij. extract to sherry wine 
fjfxxx.). Dose, f 5j-— iv.] 

1 [Phila. Med. Times, vol. iv. p. 4, 1873.] 



2 3 8 



IPECACUANHA. 



Local Actions. 



Physiological. 

The prolonged applica- 
tion of ipecacuanha to the 
skin causes some irritation, 
followed by the appearance 
of vesicles, pustules, and 
even troublesome ulceration. 
In some persons the pow- 
dered root causes violent 
irritation of the respiratory 
passages, ranging from 
symptoms resembling hay- 
fever up to a spasmodic 
condition analogous to true 
asthma. 



Therapeutical. 

The use of the slowly 
acting and pustulating forms 
of counter-irritation has 
fallen out of fashion, as they 
are not only disfiguring, but 
give less relief than more 
sedative applications. 

The only way in which we 
find ipecacuanha employed 
locally is in the form of 
spray, which Prof. Ringer 
has found very useful in 
chronic bronchitis. 



Constitutional Actions. 



1. Brain and Nervous 
System. — i. No effect seems 
to be produced on the brain. 

2. Ipecacuanha has a mark- 
edly stimulating influence on 
that centre in the medulla 
oblongata Which presides 
over the action of vomiting. 
Whether by subcutaneous 
injection, or by being taken 
into the stomach, it causes, 
within a moderate period, a 
decided but mild emetic ef- 
fect; and as this may arise 
either from irritation of the 
mucous membrane of the sto- 
mach, or from a primary stim- 
ulation of the vomiting cen- 
tre itself, ipecacuanha must be 
ranked among both the di- 
rect and the indirect emetics. 

It maybe said generally to 
occupy a middle place be- 
tween sulphate of zinc and 



2. Ipecacuanha cannot be 
recommended in cases of 
poisoning, for not only does 
it act too slowly, but its nau- 
seating and depressing influ- 
ence may be injurious. It 
is of great service, however, 
in many of those affections 
of the throat or respiratory 
organs where we wish to 
empty the lungs or detach 
foreign bodies or false mem- 
branes from the larynx or 
trachea, as in bronchitis, 
croup, diphtheria, &c. 

A most remarkable fact in 
the action of this drug is its 
power, when given in small 
doses, of checking vomiting. 
Thus, in the vomiting of 
pregnancy, in the irritability 



IPECACUANHA. 



2 39 



tartar emetic, being neither 
so prompt as the first, nor so 
nauseating as the second. 



II. Circulation. — Ipecacu- 
anha has no direct influence 
on the heart or circulation, 
save the usual depression fol- 
lowing nausea and vomiting. 

III. Respiration and Tem- 
perature. — No effect is pro- 
duced on the rapidity of the 
respiratory function, save the 
temporary acceleration usu- 
ally accompanying the act of 
vomiting. There seems no 
doubt, however, that ipeca- 
cuanha causes an increased 
secretion from the mucous 
membrane of the bronchial 
tubes. After poisoning by 
ipecacuanha, the lungs have 
generally been found in a 
bloodless condition. 



IV. Digestive and Secret- 



ing Organs 



i. Stomach and 
Intestines. — As already 
noted, ipecacuanha causes 
some irritation of the termi- 
minal filaments of the pneu- 
mogastric nerve distributed 
to the stomach, and thus sets 
in motion the reflex machin- 
ery necessary to produce 



of stomach of children, and 
in other dyspeptic condi- 
tions, a drop of ipecacuanha 
wine taken every hour will 
often prove truly curative. 
At present this must be look- 
ed upon as one of the enig- 
mas of therapeutics. 



III. Ipecacuanha is there- 
fore a most useful expecto- 
rant, thinning and diluting 
the pulmonary mucus, and 
thus facilitating its expulsion. 
It is hence almost universally 
employed in bronchitis, com- 
mon catarrh, winter cough, 
&c. It was formerly used, 
and with some alleged suc- 
cess, in hemoptysis, 5 -grain 
doses repeated at short inter- 
vals exerting a marked de- 
pressing effect, and thus 
checking the tendency to 
bleeding; but with the. intro- 
duction of more effectual re- 
medies, this mode of treat- 
ment has now fallen into 
disuse. 

IV. — 1. Ipecacuanha is 
indicated in some overload- 
ed conditions of the stomach, 
caused by excessive indul- 
gence either in food or drink; 
and the dull aspect, coated 
tongue, foul breath, head- 
ache, and nausea, may be 
promptly relieved by a good 
emetic dose. 



240 



IPECACUANHA. 



vomiting. On the mucous 
lining of the intestinal canal, 
also, its effects are undoubt- 
ed, as indicated by its action 
in disease \ but we are at pre- 
sent unable to give any satis- 
factory explanation of its 
often marvelous influence 
over dysentery in its various 
forms. 



2. Liver. — Ipecacuanha 
seems to have some stimu- 
lating power over the hepatic 
secretion. 



3. Skin. — Ipecacuanha 
promotes slightly the cuta- 
neous secretion, independ- 



In acute dysentery, ipeca- 
cuanha is now looked upon as 
a never-failing specific. It 
must here be taken in full 
doses, from 15 to 20 grains 
being given at once and re- 
. peated in two hours ; and al- 
though the first dose may be 
rejected by the stomach, 
toleration is speedily estab- 
lished, and no more vomiting 
is produced. Some authori- 
ties recommend a previous 
administration of laudanum 
to quiet the stomach. 

Under this treatment the 
pain and tenesmus rapidly 
subside, the motions regain 
natural color and consist- 
ence, and the patient makes 
a satisfactory recovery. 

In cases of dysenteric diar- 
rhoea so often met with in 
this country, and more espe- 
cially in children, ipecacu- 
anha in much smaller doses 
is also a very effectual re- 
medy, the indications for its 
use being any appearance of 
blood or mucus in the stools, 
with pain and straining. In 
the more ordinary forms of 
diarrhoea, however, it is 
quite useless. 

2. It has therefore been 
given in the form of pill, and 
combined with other reme- 
dies, to relieve the sluggish 
digestion caused by a defici- 
ency of bile. 

3. Ipecacuanha combined 
with opium, in the form of 
''Dover's Powder," is a 



JALAP. 241 

ent of the tendency to per- well-known and tolerably 
spiration usually attending effectual diaphoretic, much 
the action of emetics. used in chronic rheumatism 

and feverish attacks. 

Mode of Elimination, &c. 

It is probable that as much of the ipecacuanha as remains 
after the action of vomiting is eliminated from the system 
by the biliary and intestinal secretions. 

Mode of Administration. 

The action of ipecacuanha wine is so notoriously uncer- 
tain, that, when we wish to obtain the full emetic effect of 
the drug, it is best to have recourse to the freshly powdered 
root (15 to 30 grains), remembering, however, that chil- 
dren will bear unusually large doses. 

In the treatment of dysentery also, we shall derive most 
advantage from the use of the powder, and in ordinary 
cases of dysenteric diarrhoea we may give from ^ to 2 or 
3 grains in combination with compound tragacanth powder. 

Vinum ipecacuanhas, in doses of from n^x. to 5j-> is an 
almost invariable ingredient of cough mixtures. 

[Emetia, the alkaloid of ipecacuanha, is not officinal, but 
is an efficient emetic in doses of gr. j\ to ^.] 



JALAPA— JALAP. 

[ The tuber of Exogonium purga {Bentham, Botanical Register), 
Ipomoea Jalapa [Ahittall), U. S. 

Dose, in substance, gr. x.-xxx. 

Officinal Preparations, U. S. 

Extractum Jalapae. Dose, gr. v.-x. 
Pulvis Jalapae Compositus (jalap 1 pt., cream of tar- 
tar 2 pts.). Dose, gr. xx.-3j. 

Resina Jalapae. Dose, gr. ij.-iv. 

Tinctura Jalapae (powder ^iij.-Oj.). Dose, 3j--ij-] 

Physiological Action. Therapezttical Action. 

The action of jalap resem- Jalap is undoubtedly one 

bles that of scammony, only of our best hydragogue ca- 

differing in being less irri- thartics, and is much used in 

tant and more effectual in cerebral lesions, in kidney 

21 



242 BUTTERNUT — JUNIPER. 

promoting the flow of watery disease, where the excretion 
fluids from the bowels. of effete products threatens 

to become suspended, and 
when dropsy is setting in ; 
in such cases smart purgation 
by pulv. jalap, co. will often 
produce striking benefit. 

In cardiac disease also, 
when the right side of the 
heart is engorged by emphy- 
sema or bronchitis , free ca- 
tharsis will unload the dis- 
tended and laboring organ, 
and relieve the condition of 
intense dyspnoea, with the 
cold and livid surface and 
indications of approaching 
death. Jalap also acts well 
as an ordinary or habitual 
purgative, and is generally 
prescribed in the form of the 
compound powder, contain- 
ing cream of tartar. 



[JUGLANS— BUTTERNUT. 

The inner bark of the rsot of Juglans cinerea, U. S. 

Officinal Preparation, U. S. 

Extractum Juglandis. Dose, as a laxative, gr. v.-x.; 
as a purgative, gr. xx.-xxx. 

Juglans is an indigenous cathartic resembling rhubarb in 
its property of evacuating without debilitating the bowels. 
Mild and efficient in its action, it is well adapted to habit- 
ual constipatio?i. It may be given in decoction, or in the 
form of the officinal extract.] 



JUNIPERUS— JUNIPER. 

[ The fruit of Juniperus communis, U. S. 

Officinal Preparations, U. S. 
Infusum Juniperi (berries 3j. to Oj.). Dose, f^iv.-Oj. 
Oleum Juniperi. Dose, gtt. v.-xv. 



KI NO. 



243 



Spiritus Juniperi Compositus (oil f3jss. in Oviij.). 
Dose, fjij.-iv. 

Spiritus Juniperi (oil f 3J. in Oiij.). Dose, fjss.-j.] 



Physiological Action. 

Juniper stimulates the 
action of the kidneys, but, 
lik° many other remedies of 
its class, only increases the 
flow of urine where dropsy 
exists. It has been shown 
that in a healthy man the 
quantity of the urine is 
actually diminished, whilst 
the urea is increased. 

[When an overdose is 
given, even strangury and 
total suppression may result. 
In small doses it is a gentle 
stimulant to the kidneys.] 



I£. Spiritus juniperi 
Potassii acetatis 
Spiritus ?etheris nitrosi 
Decocti scoparii [Br.] 

S. Dose, f^j. ter die 



Therapeutical Action. 

Juniper is a good diuretic, 
generally used in combina- 
tion with other drugs, and 
acting either when swal- 
lowed, or inhaled in the 
form of vapor. 



f ^ss. ; 

5i ss - ; 
'Si- ; 

f §viij. 



M. 



Diuretic mixture. 



KINO— KINO. 



[ The inspissated juice of Pterocarpus Marsupium {De Candol/e), 
and of other plants, U. S. 

Officinal Preparation. 
Tinctura Kino (^jss. to Oj.). Dose, f3j.] 



Physiological Action* 

Kino is astringent in vir- 
tue of the tannin which it 
contains. 



Therapeutical Action. 

It may therefore be used 
in diarrhoea and other cases 
where astringents are indi- 
cated, but it seems to have 
no special advantage over 
other remedies of the same 
class. 



244 RHATANY — LAVENDER, 

KRAMERIA— RHATANY. 

\_The root of Krarneria triandra (De Cando/fe), U. S. 

Dose, in substance, gr. xx. 

Offtcinal Preparations, U. S. 
Extractum Kramerise. Dose, gr. v.-x. 
Extractum Krameriae Fluidom. Dose, gtt. xx. 
Infusum Krameriae (Jj. to Oj.). Dose, fgj.-ij. 
Syrupus Krameriae. Dose, f^ss. 
Tinctura Krameriae (^iij. to Oj.). Dose, foj.-ij.] 

Physiological Action. Therapeutical Action. 

Krarneria has powerful Rhatany has been used 
astringent properties, due, with success in dysentery and 
no doubt, to the tannin diarrhoea, but is probably 
which it contains. [It is inferior to many other 
also gently tonic, and is remedies of the same class, 
much esteemed in Peru in and is therefore but seldom 
treatment of bowel affec- employed. [It is frequently 
tions.] added to chalk mixture, in 

the treatment of diarrhoea 
of relaxation.] 



[LACTUCARIUM— LACTUCARIUM. 

The concrete juice obtained from Lactuca sativa, by incision and 
spontaneous evaporation, U. S. 

Dose, gr. xx. 

Officinal Preparation, U. S. 
Syrupus Lactucarium (,fj. to Oj.). Dose, f^ss. 

Lettuce-opium is a feeble narcotic, and is considered 
slightly laxative and diuretic. It has been used as a sub- 
stitute for the other narcotics in phthisis and in diseases of 
children.~\ 



[LAVANDULA— LAVENDER. 

The flozvers of Lavandicla vera {De Cando/ie), U. S. 

Officinal Preparations, U. S. 

Oleum Lavandulae. Dose, gtt. iij.-x. 
Spiritus Lavandulae. Dose, f^ss.-j. Enters into 
Mistura Ferri Composita. 

Spiritus Lavandulae Compositus. Dose, 5J-~i v - 



LEPTANDRA — LEMON. 245 

Lavender is a carminative, but is rarely used except in 
combination. The compound spirit is its most elegant 
preparation, and is a very agreeable stomachic and cordial. 
The oil is used in perfumery.] 



LEPTANDRA— LEPTANDRA. 

The root of Leptandra Virginica, U. S. 

Culver's root is emetic and cathartic, and is also con- 
sidered cholagogue. Dose of the powdered root, gr. xx. 
to 3j. In small doses (gr. ij.-v.), it is said to resemble 
rhubarb. The fluid extract (not officinal) is aperient in 
doses of T7r,x. to f3j.] 



LIMONES— LEMON. 

[ The fruit of Citrus Limonum, (J. S. 

Limonis Cortex. Lemon Peel. 

Limonis Succus. Lemon Juice. Dose, f^j.-iv. 

Oleum Limonis. 

Acidum Citricum. 

Officinal Preparations, U. S. 

Spiritus Limonis. Used for flavoring purposes. 
Mistura Potassii Citratis. Neutral Mixture. Dose, 

Syrupus Limonis. As a vehicle. 

Spiritus Ammoniae Aromaticus, Dose, f3ss.-j. 

Syrupus Acidi Citrici. As a vehicle.] 

Constitutional Action. 

Lemon-peel is in some measure tonic and antispasmodic, 
and is a useful flavoring ingredient, but lemon-juice has 
some important properties which are purely therapeutical, 
and cannot be explained by any action which it possesses 
over the healthy organism. 

In the first place we must rank its antiscorbutic virtues, 
acting as it does both by preventing and by curing the dis- 
ease, and by its universal use afloat almost stamping out 
the ravages of what used to be an almost invariable attend- 
ant on long voyages at sea. The occurrence of scurvy to 
any extent on board ship is now looked upon as a clear 
indication that the regular administration of lime or lemon 
juice has been neglected, and that the crew has been at- 

21* 



246 LINIMENTS — FLAXSEED. 

tacked by a painful and dangerous disease, the absolute 
preventability of which experience has amply confirmed. 
Various explanations have been given of the cause of 
scurvy, and there is no doubt that it is usually associated 
with an absence of fresh meat and vegetables from the diet 
scale. Dr. Garrod, however, goes further, and teaches 
that the essence of the disease lies in a deficiency of the 
potash salts; whilst Mr. Morgan, of Dublin, is no less 
convinced that the absence of phosphoric acid is the real 
cause — both agreeing in this, however, that the presence 
of this special ingredient in lemon-juice explains its supe- 
riority over citric acid, which is in no degree an antiscor- 
butic. It is unfortunate that lime-juice is bulky, and liable 
to become solid at low temperatures, and must be also 
administered in such considerable doses as to give some 
excuse for its occasional neglect on expeditions where 
every ounce of extra weight entails increased toil and dan- 
ger. It is to be hoped that some more convenient and 
portable means of using this invaluable drug may yet be 
introduced. 

Lemon-juice was formerly vaunted as a specific for acute 
rheumatism, and although this has not been confirmed by 
experience, there is no doubt that persons afflicted with 
chronic rheumatic pains may often derive benefit from tak- 
ing a tablespoonful of this agreeable remedy two or three 
times a day with their meals. Lemon-juice has also been 
called a refrigerant, but its sole claim to this title rests upon 
the great facility with which we may construct refreshing 
effervescing draughts by its aid. 



[Linimenta. 

The officinal Liniments are : — 

Linimentum Aconiti Linimentum Chloroformi 

" Ammonise " Plumbi Subacetatis 

" Calcis " Saponis 

" Camphorse " Terebinthinse ] 

" Cantharidis 



LINUM— FLAXSEED. 

[ The seed of Linum usitatissimum, U. S. 

Oleum Lini. Flaxseed oil (Linseed oil). 
Lini Farina. Linseed meal. 



FLAXSEED. 



247 



Officinal Preparations, U. S. 

Infusum Lini Compositum. As a demulcent. Dose, 
flj-iv. 

Ceratrum Resinae Compositum. Deshler's Salve. 
Linimentum Calcis. Carron oil. For burns.] 

Local Action. 



Physiological. 

Linseed meal, in the form 
of poultice, is the most con- 
venient and effectual way of 
applying continuous moist 
warmth to the surface of the 
body. Thus used, it re- 
lieves pain, relaxes spasm, 
and is generally soothing and 
agreeable to the feelings of 
the patient. By relaxing the 
superficial vessels, a poultice 
may be in some measure an- 
tiphlogistic, and may also 
relieve the congestion of 
internal organs by drawing 
blood to the cutaneous sur- 
face and promoting perspi- 
ration there. 



Th erapeutical. 

A linseed poultice is a very 
soothing and effectual appli- 
cation in all acute affections 
of the lungs. Not only does 
it relieve pain, but it keeps 
up a warm equable temper- 
ature, and rests the affected 
organ by restricting in some 
degree the movements of 
the chest walls. It may also 
be used with advantage in 
peritonitis, in colic, in vari- 
ous inflammatory affections 
of the throat, and in boils, 
abscesses, &c , where, if it 
does not succeed in arresting 
the suppurative process, as 
occasionally happens, it fa- 
cilitates and hastens the 
breaking down of inflamma- 
tory products into pus, and 
thus encourages the process 
of ripening. After the open- 
ing of the abscess, poultices 
cannot be recommended, as 
they are nauseous and dirty, 
and we would much rather 
advise the case to be treated 
on the antiseptic principles 
of Mr. Lister. 

Linseed oil is an old-fash- 
ioned treatment for burns, 
and, combined with lime- 



248 LITHIUM. 

water, was formerly exten- 
sively used under the name 
of carron oil. 

Internal Use. 

An infusion of linseed is Under the name of linseed 
rather soothing in character, tea, this infusion is much 
probably owing to the mu- used in domestic medicine 
cilage which it contains. as a soothing remedy for 

coughs. 

Mode of Administration. 

When used as an application in pleurisy or pneumonia, 
a poultice must extend fairly round the chest, must be at 
least half an inch thick, and must be changed not seldomer 
than every two hours, as it soon tends to become dry, hard, 
and uncomfortable. It is best made by boiling the meal 
for a few minutes, and afterwards incorporating with it a 
certain amount of olive oil, which prevents its adhering to 
the surface. Occasionally its use seems to irritate the skin, 
and cause a crop of small boils and painful pustules, and 
it must therefore, as a general rule, be avoided in moist 
cutaneous affections. 



LITHIUM— LITHIUM. 

[Lithii Carbonas. Carbonate of Lithia. Dose, gr. iij. 
-vi. 

Lithii Citras. Citrate of Lithia. Dose, gr. v.-x.] 

General Physiological Effects. Th erapeutical. 

Lithia forms a very soluble Lithia is therefore a valu- 
salt with uric acid, probably able remedy for gout and 
in the blood, and therefore uric acid gravel, given either 
prevents the deposition of in the form of effervescing 
chalky formations in the lithia water, lithiae carbonas, 
tissues. or lithiae citras. 

It also causes an increase It therefore acts as a diu- 
in the urinary secretion. retic perhaps more power- 

fully than any of the other 
alkaline salts. 



LOBELIA. 



249 



LOBELIA— LOBELIA. 

[ The leaves and tops of Lobelia injlata, U. S. 

Officinal Preparations, U. S. 
Acetum Lobelia (fsij. to Oj.). Dose, from gtt. x. to 

Tinctura Lobelia (^ij. to Oj.). Dose, from gtt. x. to 
f5j-ij. 

Antidote. 

The stomach should be washed out with warm solution 
of tannic acid, and symptoms of collapse treated as they 
arise, by stimulants, frictions, counter-irritants, sinapisms, 
and anodynes.] 

Local Action. 
Lobelia possesses no local action. 



Internal Actions. 



Physiological. 

1. Brai7i and Nervous 
System. — In large doses 
lobelia frequently causes 
headache and giddiness, 
and may eventually extin- 
guish life by paralysing the 
respiratory centre. 

2. Heart and Circula- 
tion. — Lobelia depresses the 
action of the heart, and in 
this respect has a powerful 
affinity to tobacco. 

3. Respiralio?i and Tem- 
perature. — As already men- 
tioned, lobelia in large doses 
is a respiratory depressant, 
but in ordinary medical 
practice it seems to relieve 
spasmodic conditions of the 
bronchial tubes. 

It lowers the temperature 



Therapeutical. 



3. Lobelia is only used in 
medicine in this country as 
a remedy for various respi- 
ratory affections, and more 
especially spasmodic asthma. 
Its action here is apt to be 
uncertain, and it may un- 
expectedly cause much nau- 
sea and discomfort ; but 



25° 



L 1 Q U O R S 



in some measure, on account 
of its diaphoretic action. 



Ringer tells us that we may 
employ it with great confi- 
dence by giving much larger 
doses than are usually pre- 
scribed. 

Remember that its action 
in no way prevents the 
asthmatic attack, but merely 
cuts it short. 

4. Lobelia is never used 
as an emetic, being slow, 
uncertain [harsh], and ex- 
hausting. 



4. Secreting and Digestive 
Organs. — Lobelia has un- 
doubted emetic properties, 
and frequently causes vomit- 
ing, accompanied by much 
nausea and general depres- 
sion. 

Skin. — Lobelia excites the 
action of the skin. 

Kidneys. — Lobelia is said 
to promote the excretion of 
watery fluids by the kidneys. 



Dose. 

Ringer tells us that the dose laid down in our usual text- 
books is much too small, and that we may freely administer 
a drachm of the ethereal tincture [same strength as tinct. 
lobelia, U. S.] every hour, or 10 minims every ten minutes, 
with advantage, immediately before and during the asth- 
matical paroxysm. [The vinegar of lobelia is the best 
preparation for internal use.] 

The great drawback to its use is the occasional unpleasant 
symptoms following its administration, and which can be, 
unfortunately, neither foreseen nor prevented. 



[Liquores. 

The officinal Liquors are : — 



Liquor Ammonii Acetatis 

" Arsenici Chloridi 
" " et Hydrarg. Iodidi 

" Barii Chloridi 

" Calcii Chloridi 

" Calcis 

" Ferri Chloridi 



Liquor Ferri Citratis 
" " Nitratis 

" " Subsulphatis 

" " Tersulphatis 

" Gutta-perchse 

" Hydrargyri Nitratis 

" Iodinii Compositus 



LYCOPODIUM — MAGNESIUM. 251 

Liquor Magnesii Citratis Liquor Potassii Citratis 

" Morphia Sulphatis " " Permanganatis 

" Plumbi Subacetatis " Sodse 

" " " Dilutus " " Chlorinatae 

" Potassae " Sodii Arseniatis 

" Potassii Arsenitis " Zinci Chloridi.] 



[LYCOPODIUM—LYCOPODIUM. 

The sporules of Lypoc odium davatum, and other species of 
lycopodium, U. S. 

Lypocodium is an extremely fine, very light powder, of 
a delicate yellow color, inodorous, tasteless, and very 
inflammable, so that it flashes like gunpowder when thrown 
into the flame. It is used as a dusting powder for exco- 
riated surfaces, and to coat pills in pharmacy.] 



MAGNESIUM— MAGNESIUM. . 

[Magnesii Carbonas. Carbonate of Magnesia. Dose, 
£ss.-3j. 

Magnesii Sulphas. Sulphate of Magnesia (Epsom 
salts). Dose, §ss.-j. 

Officinal Preparations, U. S. 

Magnesia. Dose, §j.-3iv. 

Trochisci Magnesise (each containing gr. iij.). 

Liquor Magnesise Citratis. Dose, f^ij.-iv.] 

Internal Uses. 

Magnesia and its carbo- They are therefore antacid, 
nate have a great capacity and relieve pain or heart- 
for saturating and neutralis- burn, and are also gentle 
ing acid, and secondly, on purgatives, much used, more 
becoming converted into bi- especially for children, 
carbonate by the carbonic Their tendency, however, to 
acid of the intestines, they form concretions, when em- 
produce a mildly laxative ployed too long, limits their 
effect. use in this respect. 

Sulphate of magnesia acts Sulphate of magnesia is a 

much more powerfully, and very commonly used purga- 

causes profuse watery evacu- tive in doses of from 3j- to 

ations, and its action maybe §ss. in simple constipation, 

thus explained : — in the early stages of small- 



252 MAGNESIUM. 

In virtue of its low diffu- pox and feverish conditions, 
sive power, it does not rea- in chronic lead-poisoning, 
dily find its way into the and, combined with iron, in 
blood, but, remaining in the many atonic conditions of 
intestines, it attracts and the system, 
firmly retains the watery fluid 
it finds there, and thus pre- 
vents its reabsorption. But, 
in addition to this, recent 
experiment has shown that 
it also actually withdraws 
fluid from the veins, as 
proved by the rapid way in 
which a small portion of in- 
testine isolated from the rest 
of the tube becomes filled 
with watery fluid after the 
introduction of sulphate of 
magnesia. 

Mode of Administration. 

As sulphate of magnesia is not only very nauseous, but, 
when taken alone, may cause griping, straining, or uncom- 
fortable abdominal distension, it is usually prescribed in 
combination with senna, cardamoms, and liquorice, as in 
the mist, sennse co. [Br.], or with a little acid and sulphate 
of iron, both of which seem to increase its purgative proper- 
ties ; and it is well to remember that free dilution also 
seems to enhance its effects. The following are good for- 
mulae : — 

R. Magnesias sulphatis §'j-j 

Syrupi zingiberis 1 §ss. ; 

Infusi rosae [comp. ] ad f ^viij. M. 

S. §j. tertiis hons. 

R. Magnesise sulphatis §ij-j 

Ferri sulphatis gr. xxiv. ; 

Acidi sulphurici diluti f 5U- > 

Infusi quassias ad f §viij. 

Misce, fiat mistura, cujus capiat unciam unam omni mane. 

B.. Magnesias sulphatis §ij. ; 

Magnesias carbonatis 3 lb > 

Syrupi zingiberis ffj-J 

Aquae menthae piperitse ad f §viij. 

Misce, fiat mistura. Sumat unciam unam quartis horis 
ad efFectum, phiala prius bene agitata^ 



MANGANESE MARBLE. 253 

[MANGANESIUM— MANGANESE. 

Manganesii Oxidum Nigrum. Black oxide of manga- 
nese (used in making oxygen, chlorine, and aqua chlo- 
rini) has been administered in doses of gr. iij.-xx. 

Manganesii Sulphas. Sulphate of Manganese. Dose, 
gr. v.-xx. 

Internal Effects and Uses. 

Sulphate of manganese acts as a purgative in doses of 
5j.-ij., and in smaller doses has cholagogue properties. 
Dr. Hammond reports its successful use in chorea. In 
divided doses it has been given m gastr a Igia, pyrosis, and 
indigestion^ 



MANNA— MANNA. 

[ The concrete saccharine exudation in flakes of Fraxinus Omits, and 
of Fraxinus rotundifolia, U.S.~\ 

Internal Effects and Uses. 

Has very slight purgative properties. [It is generally 
given in infusion combined with senna, but may be used 
alone boiled in milk for children, to whom its sweet taste 
makes it acceptable. Dose, for a child, 3j-- n j-] 



[MARANT A— ARROWROOT. 

The fecula of the rhizome of Mar ant a Arundinacea, U. S. 
Enters into Trochisci Ipecacuanhas. 

Uses. 

Arrowroot is demulcent, and forms an agreeable article 
of diet for the sick and for infants. A tablespoonful to a 
pint of water, flavored with lemon and sugar, may be used 
for invalids, or a decoction in milk for children.] 

[MARMOR— MARBLE. 

Native, white, granular Carbonate of Calcium. 

Used as a source for Carbonic Acid Gas and in making 
Aqua Acidi Carbonici, and Liquor Calcii Chloridi. (See 
Calcium.)] 
22 



254 HOREHOUND — HONEY. 

[MARRUBIUM— HOREHOUND. 

The leaves and tops of' Marrubhwi vulgar e, U. S. 

Used as a domestic remedy for catarrh, in the form of 
decoction (3j.°to Oj.), syrup, and candy.] 

MASTICHE— MASTIC. 

[ The concrete resinous exudation from Pistacia Lentiscus, U. S. 

Enters into Pilulae Aloes et Mastiches.] 
This is only used as a filling for decayed teeth in dental 
surgery. 



MATICO— MATICO. 

\_The leaves of Artanthe elongata (Miguel), U. S. 

Officinal Preparation, U. S. 

Extractum Matico Fluidum. Dose, f3ss.-j.] 

Matico is only used externally as a local application for 
the arrest of hce?norrhage j and it is generally believed that 
it acts mechanically by the roughly-reticulated under- 
surface of the leaf entangling the blood and forming clots. 
No success has attended its internal administration. [In 
the form of the fluid extract, Matico has been highly re- 
commended in hemorrhages and diseases of mucous mem- 
branes, including gonorrhoea and leucorrhoea.~\ 

[MATRICARIA— GERMAN CHAMOMILE. 

The flowers of Matricaria Chamomilla, U. S. 

Resembles chamomile in its properties, but is rarely 
used in America.] 

[MEL— HONEY. 

A saccharine liquid prepared by Apis mellifica, U. S. 

Officinal Preparation, U. S. 

Mel Despumatum. 

Uses. 

Enters into Confectio Aromatica, Confectio Opii, Con- 
fectio Rosse, Oxymel (Br.), Mel Rosas, Mel Sodii Boratis, 



PEPPERMINT MEZEREON. 255 

Pilula Ferri Carbonatis, Pilulse Quinise Sulphatis, Tinctura 
Cardamomi Composita, and Tinctura Opii Composita. 

The agreeable taste and demulcent qualities make honey 
a useful vehicle for distasteful powders, and render it an 
acceptable addition to gargles. Purified honey is a good 
excipient for pills, and forms the basis of the Mellitse. 1 ] 



[MENTHA PIPERITA— PEPPERMINT. 

The leaves and tops of Mentha piperita, U. S. 

MENTHA VIRIDIS— SPEARMINT. 

The leaves and tops of Mentha viridis, U. S. 

Officinal Preparations, U. S. 

Aqua Menthse Piperitse. Used as a vehicle. 
Oleum Menthse Piperitse. Dose, gtt. iij.-x. 
Spiritus Menthse Piperitse. Dose, gtt. x.-xx. 
Trochisci Menthse Piperitse. 
Aqua Menthse Viridis. Used as a vehicle. 
Oleum Menthse Viridis. Dose, gtt. iij.-x. 
Spiritus Menthae Viridis. Dose, gtt. x.-xx. 

Peppermint and spearmint are favorite stimulant stom- 
achics, and are much used as vehicles in mixtures. The 
troches of peppermint are a popular carminative.] 



MEZEREUM— MEZEREON. 

\_The bark of Daphne Mezereum and of Daphne Gnidium, U. S. 

Officinal Preparations, U. S. 

Decoctum Sarsaparillse Compositum. Dose, f^iij. 
-iv. 

Extractum Mezerei Fluidum (used in Ung. Mezerei). 

Extractum Sarsaparillse Compositum Fluidum. 
Dose, 5ss.-j. 

Unguentum Mezerei (a stimulant dressing).] 

This drug is never used save as a constituent of the 
decoctum sarsaparillse co. 

1 [The class of Mellitse, or Honeys, comprises Mel Rosse and Mel 
Sodii Boratis, which are used chiefly in washes for the throat and 
mouth.] 



256 HORSE MI NT NUTMEG. 

[Misturae. 

The officinal Mixtures are: — 

Mistura Ammoniaci Mistura Cretse 

" Amygdalae " Ferri Composita 

" Assafoetidse " Glycyrrhizse Composita 

" Chloroformi " Potassii Citratis.] 



[MONARDA— HORSEMINT. 

The leaves and tops of Monarda punctata, U.S. 

Officinal Preparation, U. S. 

Oleum Monardae. Dose, gtt. ij.-iij. 

Effects and Uses. 

The oil is used in domestic practice for sick stomach and 
flatulent colic j like the other mints, it is stimulant and 
carminative. Applied to the skin it is rubefacient, even 
vesicant, and has been employed as counter-irritant in 
chronic rheumatism t infantile paralysis, and in low fevers .] 



[MOSCHUS— MUSK. 

A peculiar concrete substance obtained fro7?i Moschus Mbschiferus, U. S. 

Internal Effects. 

Has undoubted antispasmodic powers, but has been 
almost entirely discarded on account of its high price and 
frequent adulteration. It may be given in doses of gr. v. 
-xv., in hysterical convulsions ', hiccough, in low fevers and 
delirium treme?is. Castoreum makes an efficient substitute 
for musk.] 



[Mucilagines. 

The officinal Mucilages are: — 

Mucilago Acacise Mucilago Tragacanthae 

" Sassafras Medullae " Ulmi.] 



MYRISTICA— NUTMEG. 

[The kernel of the fruit of Myristica fragrans (Houttuyn, Nat. Hist.), 

U. S. 

Officinal Preparations, U. S. 

Spiritus Myristicae. Dose, f5j. 

Oleum Myristicae. Volatile Oil of Nutmegs. Dose, 
gtt. ij.-iij. 



MACE MYRRH. 257 

MACIS— MACE. 

The aryllus of the fruit of Myristica fragrans (Houttuyn, Nat. Hist.), 

U.S. 

Enters into Acetum Opii, Pulvis Aromatictis, Spiritus 
Ammoniae Aromaticus, Spiritus Lavandulae Compositus, 
Spiritus Rhei Aromaticus, Trochisci Cretae, Trochisci Mag- 
nesias, and Trochisci Sodii Bicarbonatis.] 

Nutmeg is rarely used in medicine save as a flavoring 
ingredient. [The dose of Nutmeg or Mace in substance 
is gr. xv. With its aromatic qualities, nutmeg unites con- 
siderable narcotic power, and in doses of 3ij--iij- has pro- 
duced stupor and delirium.] 



MYRRHA— MYRRH. 

\_A gum-resinous exudation from B alsamodendron Myrrha^ (Nees, 
Beschreib. OfflcineL Pfianzen). 

Dose, in substance, gr. x.-xxx., U. S. 

Officinal Preparations, U. S. 

Tinctura Myrrhae (^jss. to Oj.). Dose, f5ss.-j. 
Tinctura Aloes et Myrrhae. Dose, f5j--ij- 

Also enters into Mistura Ferri Composita, Pilulae Aloes 
et Myrrhae; Pilulae Ferri Compositae, Pilulae Galbani Com- 
positae, and Pilulae Rhei Compositae.] 

Local Uses. 
Physiological. Therapeutical. 

Myrrh is astringent, and It is a useful addition to 
checks excessive secretion gargles in relaxed or ulce- 
from mucous surfaces. rated conditions of the 

throat ; it is a good applica- 
tion to spongy or unhealthy 
gums, as in mercurial saliva- 
tion ; and it often forms one 
of the active constituents of 
lotions for foul ulcers ; where 
it gently stimulates the gran- 
ulating surface, and corrects 
the fcetor of discharges. 
22* 



2 5 8 



bebeeru bark, 
Internal Uses. 



Like all the gum balsams 
and resinous substances, 
myrrh may possess in some 
degree the power of stimu- 
lating mucous surfaces. Tra- 
dition and the habit of pre- 
scribes have also invested it 
with some supposed influ- 
ence over the uterus ; but no 
trustworthy evidence has 
ever been brought forward 
on this point, and it is more 
than probable that its em- 
menagogue influence is quite 
secondary to the other drugs 
in combination with which 
it is prescribed in these cases. 



R. Aluminis 

Tincturce myrrlice 
Infusi rosae [comp.J 

Misce, fiat gargansma. 



Myrrh has occasionally 
been used as a stimulant in 
chronic bronchitis, but practi- 
cally its application in medi- 
cine is now restricted to the 
administration of the various 
forms of pill in amenorrhoza ; 
and here it is impossible to 
separate its action from the 
aloes with which it is invari- 
ably combined. 



5u- ; 

ad f^x. 



NECTANDRA— BEBEERU BARK. 

\The bark of Nectandra Rodiei [Sckomburgh), U. S.~\ 

The bebeeru bark possesses some of the physiological 
properties of quinine. Thus it arrests the movements of 
the white blood-corpuscles, and checks the development 
of bacteria; but unfortunately it does not in any way fulfil 
the same therapeutical indications, save acting as a tonic, 
in virtue of its bitterness. 

[Like cinchona, it contains several alkaloids, the princi- 
pal one having received the name of beberia, a sulphate of 
which is officinal in the Ph. Br., but not officinal in the 
United States. The antiperiodic dose of the sulphate of 
beberia is gr. xx.~3j. (It should not be confounded with 
berberina, the active principle of the simple bitters.)] 



NUX VOMICA. 



2 59 



NUX VOMICA— NUX VOMICA. 

\_The seed of Strychnos Nux Vo?nica, U. S. 

Officinal Preparations, U. S. 

Tinctura Nucis Vomicae (^iv.-Oj.). Dose, nrx. 
Extractum Nucis Vomicae. Dose, gr. % to ^. 
Strychnia and Strychniae Sulphas. Dose, gr. ^V - !-] 

Antidotes. 

In a case of strychnia poisoning, we may first administer 
tannin, which places the drug in an insoluble form, then, 
after evacuation of the stomach, it will be necessary to try 
the physiological antidotes. These are chloral, bromide 
of potassium, Calabar bean, and nicotia [or tobacco ene- 
mata], although the use of the last-mentioned remedy must 
be conducted with extreme caution. Finally, we may 
have recourse to artificial respiration. 

Local Action. 
No special local action has been noted. 

Constitutional Action. 

i . Brain and Nervous Sys- 
tem. — No effect is produced 
on the brain, the cerebral 
functions remaining unim- 
paired almost up to the close 
of a case of strychnia-poison- 
ing. 

The spinal cord, however, 
is early attacked, and vio- 
lent and distressing tetanic 
spasms prove the irritating 
influence of the drug, more 
especially on the reflex exci- 
tability of that organ. 

In large doses, strychnia 
also paralyses the efferent 
(motor) nerves, causing loss 
of power of voluntary move- 
ment. 

The sympathetic system is 
stimulated. 



i. Nux vomica, and more 
especially strychnia, are ex- 
cellent nervine tonics, acting 
well in simple debility, ner- 
vous exhaustion, and inconti- 
7ience of urine, and promot- 
ing the return of function 
after some forms of paralysis. 
When all inflammatory 
symptoms have subsided, 
strychnia may be prescribed 
in the hope of stimulating the 
spine to resume its duties, 
and restoring tone to mus- 
cles which long remained 



260 



NUX VOMICA. 



2. Heart and Circulation. 
Strychnia causes rise of 
arterial pressure and con- 
traction of the capillaries. 

3. Respiration and Tern- 
perature. — The interference 
with breathing observed in 
strychnia - poisoning, and 
which usually terminates the 
life of the victim, is due to 
spasmodic fixation of the 
diaphragm and respiratory 
muscles, 

4. Digestive and Secret- 
ing Organs. — Strychnia has 
a tonic influence over the 
digestive process. 



in a state of inactivity. Thus, 
in paraplegia, hemiplegia, 
diphtheritic paralysis, and 
wrist-drop, strychnia may 
well go hand in hand with 
galvanism when all evidence 
' of irritation of the nervous 
structures has completely 
disappeared. Mr. Barwell 
has proposed subcutaneous 
injections of strychnia in in- 
fantile paralysis, using a 
large dose ( T V to T V gr.), 
and forcing the fluid freely 
into the muscular structures. 
[To begin with, a much 
smaller dose should be ex- 
hibited. One-half a grain, 
by the mouth, has killed an 
adult.] 



4. Strychnia, and more 
especially nux vomica, are 
excellent tonics, improving 
the appetite in a marked 
degree ; but, in addition to 
this, nux vomica is of great 
service in various dyspeptic 
conditions, relieving heart- 
burn, nausea, and. flatulence, 
and being also a reliable 



NUX VOMICA. 261 

remedy in sick headache and 
the vomiting of pregnancy. 
It is an excellent addition 
to purgative pill masses, 
improving the tone of the 
muscular wall of the intes- 
tines and relieving constipa- 
tion. 

Poisonous Effects. 

As already stated, strychnia kills by inducing hyper- 
excitability of the reflex functions of the spine, with vio- 
lent tetanic spasms, leading to death by exhaustion or 
suffocation. The fatal event may take place in a few 
minutes if the dose be a large one, and the minimum 
quantity required to destroy life is about half a grain. 
Contrary to the habit of other poisonous drugs, strychnia 
acts most rapidly and efficiently when given by the rectum. 

Dose, Mode of Administration, &c. 

The dose of strychnia may be put at from -^ to T \ gr., 
and the liquor is a convenient form, in doses of from 5 to 
10 minims, added to any ordinary tonic mixture. We are 
usually advised to suspend its administration from time to 
time, as it is stated that uncomfortable twitchings and ri- 
gidity about the jaw may suddenly arise, giving evidence 
of the so-called 'accumulation' of the drug. 

The dose of mix vomica is, of the tincture 5 to 10 min- 
ims, of the extract gr. ^ to gr. ij. 

By hypodermic injection we are usually taught that 
gr. t Jq is the proper dose, and it is therefore difficult to 
explain why no poisonous results followed Barwell's some- 
what heroic medication. 

I£. Ferri sulph. exsic. gr. xl. ; 

Quiniae sulph. gr. xl. ; 

Strychniae sulph. gr. ss. ; 

Mannae q. s. M. 

Fiant pilulae xx. Sumat unam ter die. 
A useful tonic pill. 

I£. Tinct. nucis vomicae f 5i. ; 

Acidi [nitrO-muriatici] diluti f5'J-5 

Spiritus chlorofbrmi f 5l- ; 

Infusi gentianae ad f ^vj. M. 
S. Dose, f ^j. ter die sumend. 
For flatulent colic, taken after meals. 



262 



COD-LIVER OIL 



fy. Ferri sulph. 

Ext. nucis vomicae 
Ext. aloes Barb. 

Fiat pil. ante cibum sumend. 

A good " dinner pill." 



aa gr. ss. ; 
gr. iij. M. 



[Olea. 



The officinal Oils are :- 

Oleum ^Ethereum 

" Amygdalae Am arse 

" " Expressum 

" Anisi 

" Bergamii 

" Cajuputi 

" Camphorse 

" Cari 

" Caryophylli 

" Chenopodii 

" Cinnamomi 

" Copaibae 

" Cubebae 

" Erigerontis Canadensis 

" Fceniculi 

" Gaultherise 

" Hedeomae 

" Juniperi 

" Lavandulae 

" Limonis 

" Lini 

" Menthae Piperitae 



Oleum Menthae Viridis 

" Monardae 

" Morrhuae 

" Myristicae 

" Olivae 

" Origani 

" Pimentae 

" Ricini 

" Rosse 

" Rosmarini 

" Rutae 

" Sabinae 

" Sassafras 

" Sesami 

" Succini 

" " Rectificatum 

" Tabaci 

" Terebinthinae 

" Theobromae 

" Thy mi 

" Tiglii 

" Valerianae.] 



[OLEUM ^ETHEREUM— ETHEREAL OIL, U. S. 

Heavy oil of wine is a limpid, almost colorless, volatile 
fluid, of a pungent taste and vinous odor. Its solution in 
alcohol and ether is officinal as Spiritus ^Etheris Composi- 
tus (see page 91), but it is never prescribed alone.] 



OLEUM MORRHUA— COD-LIVER OIL. 

[ The fixed oil obtained from the livers of Gadus Morrhua and of other 
species of Gadus, U. S.~\ 

Local Action. 

Cod-liver oil is not used in virtue of any local action, 
as its nauseous smell effectually prevents it from forming 
the basis of ointments or liniments. Being very readily 



COD-LIVER OIL. 



263 



absorbed by the skin, however, it is occasionally intro- 
duced into the system by this channel when the patient is 
unable to take it by the mouth. [It has been used in 
ophthalmic practice, instilled into the eye, to remove slight 
opacity of the cornea.] 

Constitutional Actions. 



Physiological. 

1 . Brain and Nervous Sys- 
tem. — Cod-liver oil can only 
be said to act on the nervous 
system by improving its nu- 
trition and supplying the 
fatty ingredients necessary 
for growth and repair. 

2. Circulation. — It has a 
tonic influence on the circu- 
lating organs, by improving 
the quality of the blood and 
strengthening the heart-mus- 
cle. 

3. Respiration and Te7?i- 
perature. — No special physi- 
ological influence is exerted 
on either of these functions. 
[In addition to its value as 
a hydro-Carbon in simply 
nourishing the body, it is 
alterative by virtue of a small 
proportion of iodine, bro- 
mine, and phosphoric acid 
which-it contains, associated 
with certain biliary princi- 
ples, in a manner, perhaps, 
best adapted to secure their 
absorption and assimilation.] 



4. Digestive and Secreting 
Organs. — It has been proved 
by experiment that animal 



Therapeutical. 

1. It is therefore specially 
indicated in all nervous affec- 
tions dependent on debility, 
such as neuralgia, some 
forms of insanity, asthma, 
whooping-cough, &c. 

2. It is therefore much 
used in simple debility, in 
convalescence from acute ill- 
ness, in ancemia, and other 
weakened conditions of the 
system. 

3. Under this heading we 
may place, for convenience, 
the wonderfully restorative 
effects of cod-liver oil in 
chronic lung disease, but 
more especially in the va- 
rious forms of pulmonary 
phthisis. It is beneficial in 
asthma and chronic bronchi- 
tis, but in consumption it 
really seems to be directly 
curative. It may be given 
with advantage in all stages, 
and under its use patients 
often rapidly gain flesh, and 
not only manage to hold the 
disease at bay, but even oc- 
casionally seem to escape 
from its clutches. 

4. Cod-liver oil is most 
invaluable in diseases de- 
pending on defective nutri- 



264 



COD-LIVER OIL. 



are much more digestible 
than vegetable oils, and cod- 
liver oil is the most readily- 
assimilated of all. After 
being emulsified by the pan- 
creatic juice, it comes in 
contact with the bile, which 
distinctly increases its power 
of passing through moist ani- 
mal membranes ; and it is 
probable also that the biliary 
principles incorporated in 
its own structure aid in en- 
abling it to be easily ab- 
sorbed by the lacteals. Its 
action on the system now is 
to improve the general con- 
stitutional tone, to evolve 
force and heat, and to aid 
in supplying those fatty ele- 
ments which are so essen- 
tially requisite for the con- 
struction and repair of the 
tissues. 

Cod-liver oil occasionally 
causes nausea, vomiting, and 
diarrhoea, and it has been 
shown to increase in some 
measure the biliary secre- 
tion. 

Mode of Elimination. 

The greater part of the oil is absorbed into the system, 
but a little is given off by the faeces ; and it is well to watch 
the evacuations of children under its influence, to see whe- 
ther any undigested oil escapes, this indicating an overdose. 

Drawbacks. Mode of Administration. 

Cod-liver oil occasionally produces so much nausea, 
eructation, and discomfort, as to compel us to suspend its 
administration ; but most patients, and more especially 
children, speedily grow accustomed to its use. It is 
advisable to prescribe it in small doses directly after meals 
or at bed-time, to give it with some light tonic, and to 



tion, as in all scrofulous 
conditions, such as strumous 
ophthalmia, caries of bones, 
chronic joint- affections, glan- 
dular enlargements, &c. ; 
also in rickets and all the 
wasting disorders of child- 
hood, in senile atrophy and 
decay, in chronic rheuma- 
tism, in all the ulcerative 
varieties of skin disease, and 
in advanced co?istitutio?ial 
syphilis. Various attempts 
have been made to explain 
the actions of the oil by 
means of certain special in- 
gredients which it contains ; 
but none of these have been 
successful, and we cannot at 
present do more than attri- 
bute its restorative influence 
to its ready digestibility and 
nutritive properties. 



OLIVE OIL CASTOR OIL. 265 

suspend it from time to time, more especially in hot wea- 
ther or when bilious symptoms supervene. It may well 
be given in combination with a little alcohol, beaten up 
with the froth of porter, with mucilage, or lemon-juice, or 
with from n^x. to f 3j- of aether purus, which, Dr. B. Fos- 
ter tells us, aids digestion by stimulating the pancreatic 
secretion ; but if the pale oil is used, very few persons 
will be found entirely rebellious to its use. Children, as 
a rule, take it well, but if they prove obstinate we may 
give it with orange wine, or in the following combination : — 
R. Olei morrhuse f^ss. ; 

Mucilaginis acacise ff'j-5 

Sacchari 5U-5 

Tincturse lavandulse comp. "H\xx. ; 
Aquse f§ss. M. 

f"5j. pro dosi. 

Black coffee forms a good medium for adults, or we may 
give the oil floating [on beer, porter, or] on the following 
mixture: — 

R. Acidi nitrici diluti TT^x. ; 

Acidi hydrocyanici [dilut.] T)lJ.-ij.; 
Tincturae aurantii f;5ss.; 

Aquas f§ss. M. 

The dose should never exceed half an ounce. 

[A pancreatic emulsion of cod-liver oil, and an emulsion 
with the lacto-phosphate of lime, or with lime-water (soap) 
flavored with oil of bitter almonds, are largely used for 
children, although not officinal.] 



OLEUM OLIV^E— OLIVE OIL. 

[ The fixed oil obtained from Olea -Europcea, U. S. 

Olive oil is nutritious and laxative, and is occasionally 
used for children as a substitute for castor oil. Dose, for 
an adult, f ^ij.-iv. It is a useful remedy for all kinds of 
irritant poisoning except from phosphorus in substance. 
It is used largely in pharmacy.] 

Olive oil is only used externally as an emollient appli- 
cation, and as the basis of various liniments. 



OLEUM RICINI— CASTOR OIL. 

The fixed oil obtained from the seeds of Ricinus communis, U. S. 
Enters into the Officinal Preparations, Collodium cum 
Cantharide and Collodium Flexile. 
23 



266 



CASTOR OIL 



External Uses. 

Castor oil is a substance of such bland and unstimulat- 
ing quality, that, were its smell less offensive, it might 
form a valuable external agent in certain cases. It is, 
however, occasionally used as a soothing application to 
the eye when extreme temporary irritation has been set 
up by abrasion of the corneal epithelium. Castor oil will 
purge when rubbed into the skin. 

Internal Uses. 



Physiological. 

Castor oil gently stimu- 
lates the peristaltic move- 
ments of the intestinal canal, 
and slightly augments the 
fluid secretions of the gut. 
Some amount of astringent 
action generally follows the 
purgative action of the drug. 

The seeds are very irri- 
tating, and cause gastro- 
intestinal irritation, three 
having proved fatal to an 
adult. 



Th erapeulical. 

Castor oil is a mild and 
efficient cathartic, emptying 
the intestines without causing 
griping or discomfort. It 
is therefore useful in all 
cases where we simply wish 
to unload the bowels ; but 
it is not a good habitual 
purgative from the subse- 
quent constipation pro- 
duced. This astringent 
action, however, gives it 
a special advantage in the 
treatment of diarrhaia, many 
cases of which depend on 
the presence of irritating 
matters in the intestinal 
canal; and under such 
circumstances, common 
sense naturally indicates the 
propriety of expelling the 
exciting cause. Dr. Geo. 
Johnson, however, goes 
further than this, and advo- 
cates the " eliminative" 
treatment of all diarrhoeas, 
as well as cholera. 

Dose and Mode of Administration. 

Although the best castor oil has but little actual flavor, 
it leaves a greasy, sickly sensation on the palate, which is 



CACAO BUTTER. 267 

exceedingly unpleasant. It is therefore important to give 
it in some form of combination, and we find floating the dose 
in a glass between two strata of whiskey or brandy [and 
cinnamon water] to be an effectual plan, or we may make 
use of the following formulae: — 

I£. 01. ricini f §ss. ; 

Mucilaginis acacias, 

Syrupi simplicis aa f 5ij. ; 

Aquae cinnamomi ad f §ij. M. 

Fiat haustus statim sumendus. 

I£. 01. ricini f.^iij- '■> 

Tinct. opii W\, x - ; 

Syrupi zingiberis ^7i)-\ 

Aquas menth. pip. ad f §ij. M. 

Fiat haustus statim sumendus. 

A good prescription for the diarrhoea of irritation. 



[OLEUM SUCCINI— OIL OF AMBER. 

The volatile liquid obtained by the destructive distillation of amber, U. S. 

Officinal Preparation, U. S. 
Oleum Succini Recti ficatum. Dose, gtt. x.-xx. 

The oil of amber is stimulant and antispasmodic, and 
has been recommended in bronchitis, hysteria, and obsti- 
nate hiccough, and is also used externally, diluted with 
sweet oil, as a sedative and rubefacient for whooping-cough, 
or for infantile convulsions, as in the mixture recommended 
by Dr. Jos. Parrish : — 

R. Olei succini rectificati, 

Tincturas opii aa f §ss. ; 

Olei olivas, 

Spiritus vini gallici aa f §ij. M. 

Fiat lotio. 

To be rubbed along the spine.] 



OLEUM THEOBROM^E— CACAO BUTTER. 

\_The concrete oil of the kernels of the fruit of Theobroma Cacao, U. S.~\ 

Oil of theobroma, being a firm, solid, and agreeable 
substance, is much used in the manufacture of suppositories. 



268 



CROTON OIL. 



[Suppositoria. 

The officinal Suppositories are : — 

Suppositoria Acidi Carbolici (each gr. j.) 
" " Tannici " gr. v. 

" Aloes 

" Assafcetidse 

" Belladonnse 

" Morphise 

Opii 
" Plumbi 

" Plumbi et Opii 



gr. v. 
gr. v. 
gr. % extract. 

gr. j. extract, 
gr. iij. plumbi acetatis. 
gr. iij. plumbi acetatis and 
gr. V 2 extract, opii.] 



[OLEUM THYMI— OIL OF THYME. 

The volatile oil obtained from Thymus vulgaris, U. S. 

Thyme is said to furnish the commercial oil of origanum. 
It is aromatic and counter-irritant, the oil being used almost 
exclusively as a local application, and is an ingredient in 
opodeldoc, the linimentum saponis camphoratum of former 
editions of the Pharmacopoeia.] 



OLEUM TIGLII— CROTON OIL. 

[ The fixed oil obtained from the seed of Croion Tiglium, U. S. ] 



Local Action. 



Physiological. 



The topical application of 
croton oil to the skin causes 
a good deal of irritation, fol- 
lowed by the appearance of 
a copious crop of papules, 
gradually developing into 
pustules. Dr. Tilbury Fox 
has described a symmetrical 
erythema of the face follow- 
ing this local employment ; 
and it is said that the addi- 
tion of an alkali favors the 
development of the counter- 



Th erapetttical. 

The local application of 
liniments containing croton 
oil was in former years a fa- 
vorite mode of using coun- 
ter-irritation in various chro- 
nic lung-affections, and it is 
still employed, more espe- 
cially in public practice. 
But its drawbacks are, that 
it has a tendency to overact 
on tender or irritable skins, 
and the pustules are liable 
to leave cicatrices, so that it 



CROTON OIL. 269 

irritant properties of the is difficult to believe it in any 
drug. way superior to other and 

milder applications. 

Internal Action. 

When taken internally, Croton oil, then, is adras- 
croton oil produces much tic purgative, valuable in 
irritation of the intestines, certain cases on account of 
running on, if the dose be its rapid and powerful action, 
sufficiently large, into a very Thus in apoplexy and other 
fair imitation of the symp- cerebral affectio?is, where it 
toms of cholera-poisoning, is of importance to obtain 
with vomiting, extreme pur- an immediate and thorough 
ging, collapse, and acute in- evacuation of the bowels, 
flammation of the intestines, and in some conditions of 

obstinate constipation, we 
find considerable advantage 
from its cautious use. 

Mode of Administration, &c. 

Croton oil has an acrid and irritating flavor, and is best 
given in the form of pill [or rubbed up with sugar]. Gar- 
rod, however, tells us that it may well be prescribed in 
combination with castor oil, and, in case the patient is 
unable to swallow, it may be placed on the back of the 
tongue. 

In an extreme case we might expect to obtain some 
purgative effect from rubbing it into the skin, as it appears 
to act by absorption through this channel. 

R. Olei crotonis Ti\ij . ; 

Micse panis q. s. M. 

Fiat pilula, statim sumenda, et horis duabus repetenda 
si opus sit. 

Or we may endeavor to keep its irritating properties in 
check by prescribing it in the following combination : — 

$. 01. crotonis TrT^_i ij . ; 

Ext. colocynth. comp. gr. xx. ; 

Ext. belladonnae gr. iij. 

Misce, divide in pil. vj., quarum sumat imam si opus sit. 

For external use, a very good liniment is contained in 
the British Pharmacopoei-a. 

23* 



270 OPIUM. 

OPIUM— OPIUM. 

\_The concrete pace obtained from the unripe capsules of Papaver som~ 
niferum, by incision and spontaneous evaporation. U. S. 

Officinal Preparations, U. S. 

Acetum Opii (black drop) (gr. j. in nrvjss.). Dose, 
nvv.-vij. 

Confectio Opii (gr. 1 in 36). Dose, 5ss. 

Extractum Opii (double strength of opium). Dose, 
gr. ss. 

Emplastrum Opii (extract 1 in 16). 

Suppositoria Opii (extract of opium gr. ss.). 

Suppositoria Plumbi et Opii (plumb, acet. gr. iij. ; 
opium ext. gr. ss.). 

Pilulse Opii (each, gr. j.). 

Pilula Saponis Composita (mass 20 per cent, opium). 

Pulvis Ipecacuanhse Compositus (Dover's Powder, 
gr. 1 in 10). Dose, gr. x. 

Tinctura Opii (gr. j. in n^xiij.). Dose, ffLxiij. 

Tinctura Opii Acetata (gr. j. in n^x.). Dose, n^x. 

Tinctura Opii Camphorata (gr. j. in fjss.). Dose, 
f 3j- to iv. 

Tinctura Opii Deodorata (gr. j. in nrxiij.). Dose, 
n^xiij. 

Trochisci Glycyrrhizae et Opii (gr. 1 in 20). 

Trochisci Morphiae et Ipecacuanhse (each, gr. ^.) 

Liquor Morphias Sulphatis (gr. j. inf^j.). Dose, 13J. 

Suppositoria Morphise (each, gr. ss.). 

Vinum Opii (gr. j. in rr^viij.). Dose, nLviij. 
( Morphiae Acetas ") 

Morphia^ Morphiae Murias > Dose, gr. T V-i-] 
(_ Morphiae Sulphas ) 

Antidotes. 

When summoned to a case of opium poisoning, the first 
indication must be to evacuate the stomach, and this is best 
effected by the stomach-pump, as the vomiting centre is too 
much paralysed by narcosis to allow of its effective stimu- 
lation by emetics. We then try to counteract the tendency 
to sleep by cold affusion, irritation of the skin, strong cof- 
fee, galvanism, and walking the patient about, and finally 
we may cautiously use atropine as the physiological anti- 



OPIUM. 



271 



dote. Although some good evidence comes to us from 
China of opium-poisoning checked by the antagonistic 
action of atropine, reports and opinions differ much on 
this head, and some authorities hold that atropine in cer- 
tain proportions may even intensify the action of morphia. 

Professor Bennett believes that atropia may be of service 
by contracting the vessels of the brain, and limiting the 
tendency to cerebral congestion. 

As a last resource, we may have recourse to artificial 
respiration. 



Local Action. 



Physiological. 



It seems very doubtful 
whether opium can be ab- 
sorbed through the unbroken 
cuticle. We are told that 
opium inspectors in India 
will remain for hours with 
their arms plunged up to 
the elbows in the inspissated 
extract, and that no narcotic 
effect is produced ; but it is 
difficult, on the other hand, 
to believe that opium is en- 
tirely devoid of a property 
which belladonna possesses 
in so remarkable a degree. 
Sir Henry Thompson is also 
strongly of opinion that the 
bladder cannot absorb 
opium. 



Th erapeutical. 

Fomentations with the de- 
coction of poppy-heads, and 
with other preparations of 
opium, have long been re- 
cognized as efficient means 
for the relief of pain in vari- 
ous inflammatory conditions, 
as haemorrhoids, erysipelas, 
conjunctivitis, &c. ; but as 
we cannot bring forward 
evidence of absorption of 
the drug, we must merely 
attribute this soothing influ- 
ence to the thorough appli- 
cation of moist heat. 



Internal Actions. 



I. On Nervous System. — 
1. Brain. — In small quantity, 
or in a less degree as the 
occasional preliminary ac- 
tion of a truly narcotic dose, 
opium is gently exciting to 
the brain, the intellectual 
faculties becoming generally 



I. — 1. Opium, being the 
most certain narcotic known, 
is very largely prescribed in 
a great variety of cases. In 
simple insoimtia, in worn-out 
conditions of the nervous 
system, in acute feveis, such 
as typhus and typhoid, where 



272 



OPIUM. 



stimulated, and the imagina- 
tion more vivid. To this, 
however, rapidly succeeds a 
dulling or deadening effect, 
drowsiness supervenes, and 
deep sleep finally sets in, 
from which the patient wakes 
within a period of time pro- 
portioned to the quantity 
of the drug administered. 
Headache, dryness of the 
mouth, and digestive dis- 
turbance are frequently ex- 
perienced, and idiosyncrasy 
may in some rare cases in- 
terfere materially with sleep 
by bringing into special 
prominence the exciting or 
stimulating properties of 
opium. It is not quite clear 
in what precise way the nar- 
cotising influence is in this 
instance produced ; but an- 
alysis would lead us to be- 
lieve that contraction of the 
cerebral vessels imitates na- 
tural sleep by inducing an 
anaemic condition of the 
grey matter of the brain. 
The resulting contraction of 
the pupil is probably central 
in origin, as it cannot be pro- 
duced by any local applica- 
tion of opium in any form. 

2. The conductivity and 
irritability of the sensory 
nerves are much diminished, 
so that pain is felt with less 
intensity. 



delirium and sleeplessness 
constitute truly dangerous 
complications, in delirium 
tremens, in the later stages of 
severe smallpox, in meningi- 
tis, acute mania, and in nu- 
merous other diseased con- 
ditions, which the reader can 
readily recall, this invaluable 
drug does most essential 
service by procuring sound 
and refreshing sleep. 



2. And even when not 
given in truly narcotic doses, 
it may also lull the sufferer 
into slumber by benumbing 
the sensory nerves and re- 
moving pain. As a sedative, 
anodyne, or analgesic, it is 
indispensable in many pain- 
ful conditions, such as neu- 



OPIUM. 



273 



3. The reflex function of 
the spinal cord is at first 
slightly increased, but sub- 
sequently becomes lessened 
in degree, and the respiratory 
centre is weakened and final- 
ly paralysed. In cold-blood- 
ed animals, as the frog, in 
which the cerebral are sub- 
ordinated to the spinal 
functions, opium causes most 
violent tetanic convulsions. 
[This happens occasionally 
in children.] 

4. The sympathetic sys- 
tem of nerves is also prima- 
rily excited, and secondarily 
depressed. 

II. Vascular System. — 
The action of the heart is at 



ralgia, sciatica, cancer, bili- 
ary or renal calculi, labor 
after-pains, colic, &c, and, 
as we shall presently see, the 
subcutaneous injection of 
morphia is the most effectual, 
as it certainly is the most 
rapid and convenient, mode 
of obtaining this action of 
the drug. 

Opium is also an excellent 
antispasmodic, and acts well 
by relieving irregular mas- 
cular contraction, as in the 
intestine causing colic, in the 
uterus tending to abortion 
or exhausting after-pains , in 
spasmodic urethral stricture; 
and its remarkable influence 
over some forms of obstinate 
ulceration must also be due 
to some nervous influence. 

3. Opium, having the pro- 
perty of arresting the mus- 
cular action of various or- 
gans, is our sheet-anchor in 
those terrible cases where 
rupture of the intestine, blad- 
der, or uterus, has occurred, 
and where the only possible 
chance of recovery consists 
in most perfect rest of the 
viscus, encouraging the heal- 
ing process, and preventing 
the escape of irritating secre- 
tions into the peritoneal ca- 
vity. 



II. The subcutaneous in- 
jection of morphia has been 



274 



OPIUM. 



first slightly quickened, but 
afterwards its beats become 
slower, the pulse fuller and 
firmer, and the arterial ten- 
sion raised, this effect being 
considered due to an influ- 
ence on the cardiac inhibi- 
tory nerves. It is noted, 
however, that shortly before 
death, in cases of opium-poi- 
soning, the pulse becomes 
feeble, rapid, and irregular. 
The stimulating action on 
the sympathetic nerves 
causes some contraction of 
the smaller vessels to accom- 
pany the use of moderate 
doses of opium. 

III. Respiration and Tem- 
perature. — The breathing 
tends to become slow from 
the paralysing influence of 
opium on the respiratory 
centre, and at the same time 
the secretion from the 
bronchial tubes is lessened. 

The temperature at first 
rises a little, but finally falls 
when sweating is established. 



IV. Digestive aiid Secret- 
ing Organs. — i. Nausea 
occasionally follows the use 
of opium, and constipation 
invariably results from dimi- 
nution of the intestinal se- 
cretions, no less than arrest 



advised by Dr. Clifford All- 
butt in angina pectoris, pal- 
pitation, and various painful 
cardiac conditions. Its con- 
tracting influence on the 
small vessels explains the 
antiphlogistic effect of opium 
in cases of peritonitis and 
other inflammatory condi- 
tions, as well as its power of 
checking coryza in its early 
stage. It also acts well as 
an astringent in some forms 
of hemorrhage, and more 
especially that from the 
lungs. 



III. Opium is the most 
soothing remedy for coughs 
of all kinds, but more es- 
pecially that of phthisis. 
It is a valuable aid in spas- 
modic asthma and the early 
stages of acute pneumonia, 
but in the later stages we 
must beware of its power of 
checking secretion, and in 
bronchitis it may do harm 
by slowing the respiratory 
movements, causing sleep 
to interfere with the due 
emptying of the bronchial 
tubes, and thus leading on 
to imperfect aeration of the 
blood and final suffocation. 

IV. — t. Opium is an ex- 
cellent astringent in diar- 
rhoea, dysentery, and British 
[or sporadic] cholera, often 
succeeding where other 
remedies fail, and for the 
relief of pain and tenesmus, 



OPIUM, 



275 



of the peristaltic movements 
of the canal. 



2. The salivary secretion 
is also diminished, causing 
dryness of the tongue. 

3. The urine is lessened 
in quantity, but opinions 
differ as to the effect pro- 
duced on its solid ingredi- 
ents. 



4. The biliary secretion 
is checked. 

5. The secretion of the 
skin is increased, perspira- 
tion generally resulting, and 
we may say generally that 
opium checks all secretions 
but that of the skin. 



nothing is better than the 
enema of the [Br.] Pharma- 
copoeia. In the diarrhoea 
of ulcerative processes, such 
as typhoid and phthisis, and 
the later stages of dysentery, 
it is truly invaluable. 



3. Opium is of great 
service in some cases of 
diabetes, checking the crav- 
ing appetite, and lessening 
the secretion of sugar. 

We must beware of its 
use, however, in advanced 
cases of renal disease, where 
it acts injuriously by check- 
ing secretion and encourag- 
ing the retention of urea in 
the blood. 



5. Opium in some forms, 
and more especially Dover's 
powder,, acts as an efficient 
diaphoretic. 



Poisonous Action. 

When opium has been given in a poisonous dose, the 
resulting sleep gradually grows deeper, the breathing be- 
comes heavy and stertorous, the face is flushed, swollen, 
and dusky, the pupils contracted to mere points, distension 
of the right side of the heart still further prevents the return 
of blood from the engorged lungs, and paralysis of the re- 
spiratory centre finally causes death by suffocation. Much 
difficulty may occasionally attend the diagnosis of opium- 
poisoning from (1) alcoholic coma, where, however, the 
pupils are usually dilated ; (2) from uraemic coma, where 
an examination of the urine, if practicable, might clear 



276 OPIUM. 

up our doubts ; and (3) from apoplectic effusion in the 
pons Varolii, where the symptoms are usually so simi- 
lar as to render an absolute diagnosis, under certain cer- 
cumstances, impossible. After death we find well-marked 
congestion of the brain. 

Cautions and Modes of Administration. 

In giving opium we must remember that human beings, 
like the lower animals, are diversely susceptible to its 
influence. Thus ducks and pigeons can swallow large quan- 
tities with impunity, whilst the horse and the dog rapidly 
fall under its influence ; and although we can hardly lay 
down any general rules to guide us in practice, we shall 
find that some persons can take Very heavy doses, whilst 
others are poisonously affected with unexpected rapidity. 
We must specially remember that children always bear 
opium badly, one drop of laudanum having proved fatal 
to an infant, that anaemic persons also are said by Traube 
to be readily susceptible. To guard ourselves as far as 
possible from risk, we shall do well to begin with a moder- 
ate dose, and invariably to ask our patient whether he 
has ever taken it before. 

As the system seems rapidly to accustom itself to the 
use of opium, we require gradually to increase the dose, 
and so completely do persons habituate themselves to the 
pleasurable sensations derived, that they willingly brave 
the resulting languor and digestive disturbance, and take 
it in enormous quantities. De Quincey used to take as 
much as 320 grains daily, and from half a pint to a pint 
of laudanum is by no means an uncommon daily allow- 
ance. Although the Turks and Chinese are the principal 
victims of this habit, much opium is also consumed in this 
way in some parts of England, and moderate opium-eaters 
abound in all ranks of society. We must therefore be 
very careful to warn our patients from time to time of the 
absorbing nature of this practice, and of its enervating 
effects on mind and body ; and although it seems evident 
that [continued] good health is altogether incompatible 
with [even] moderate opium-eating, and that its use by 
smoking is far more deleterious, still there is abundant 
evidence of the generally lowering tendency of the habit- 
ual use of this drug as an act of mere self-indulgence. 

As regards the various pharmaceutical preparations of 



OPIUM. 277 

opium, when we wish to produce sleep we generally pre- 
scribe the tincture in a medium dose, the pil. saponis co., 
or the extract ; whereas, if we merely wish to relieve pain, 
smaller doses may prove sufficient. 

The astringent action is best secured by small doses, 
which bring the stimulant properties of the drug into play; 
and an incipient coryza may often be checked by 5 or 10 
minims of laudanum, taken at bed-time. 

For diaphoretic purposes the combination with ipecacu- 
anha, as in Dover's powder (pulvis ipecacuanhas composi- 
tus), is of service ; and, for the relief of diarrhoea, we also 
call to our aid the astringent properties of chalk and kino, 
as in the pulvis cretae aromaticus cum opio [Br.], and the 
pulvis kino compositus [Br.] ; or the enema opii [Br.] may 
be soothing both in this condition and as allaying, by 
nervous sympathy, various painful conditions of the uterus 
and bladder. 

As an adjunct to cough mixtures, and as forming their 
really effective ingredient, we most conveniently prescribe 
opium under the form of either the tinctura camphorae com- 
posite or of the tinctura opii ammoniata [Br.], as in Prof. 
Christison's well-known formula: — 

I£. Syrupi scillse f §ij. ; 

Aq. menth. pip. fgij. ; 

Tmct. opii ammoniatae [Br.] f§ ss - J 

Tinct. [spiritus] lavandulse comp. f §ss. ; 

Syrupi f^j. M. 
Dose, f Jss. ter die. 

In diabetes we must push the [crude] drug boldly, to 
the extent even of from 6 to 8 grains a day. 

The many-sided actions of opium, which we have just 
described, are due to its complex constitution and to the 
large number of alkaloids which it contains. Of these, 
morphia is by far the most generally used, and in the 
form either of hydrochlorate [muriate, the sulphate], or 
the acetate, but more especially of the former, it has in 
very considerable measure superseded the crude drug, on 
which we were formerly obliged to depend. Its princi- 
pal differences from opium are as follows : — 

It is less astringent and antiphlogistic, and, by interfer- 
ing less with secretion, its use is not attended by so 
much headache, constipation, and dryness of tongue. 
It is more directly narcotic and anodyne, and is therefore 
24 



278 OPIUM. 

a more convenient remedy when we wish merely to pro- 
mote sleep or relieve pain. 

Its bulk is smaller than that of opium, and it is devoid 
of smell. 

The action of the heart becomes slower, and the arterial 
tension is raised. 

The respiration may become irregular from a depressing 
action on the vagi. 

The functions of the spinal cord are stimulated, and 
hence we occasionally meet with restlessness and muscu- 
lar twitchings, which in some of the lower animals run on 
into true convulsions. 

Irritability of the bladder is often observed, and trouble- 
some itching of the skin, depending, in some cases, on 
the development of a minute papular or vesicular eruption. 
Some years ago a favorite mode of using morphia was by 
what is known as the endermic method, in which the pow- 
der was sprinkled over the- raw surface of a blister ; but 
this has now been almost entirely superseded by the hypo- 
dermic syringe. This ingenious little instrument enables 
us to inject a small quantity of morphia in solution 
beneath the skin, and the relief to suffering is usually 
immediate, and sometimes permanent. It matters little 
whether we introduce the remedy into the immediate 
neighborhood of the painful spot, our only caution being 
to avoid the vicinity of large blood-vessels or nerves, and 
to plunge the nozzle [needle] of the syringe fairly through 
the skin into the adjacent cellular substance. Some smart- 
ing usually follows the entrance of the fluid, and inflam- 
mation and abscess may occasionally be produced ; but 
these accidents are rare, and the sting of the primary 
puncture may readily be obviated by freezing the skin with 
ether-spray. These injections are now very largely prac- 
tised for the relief of pain, and more especially in facial 
neuralgia, sciatica, lumbago, in the passage of biliary or 
renal calculi, in cancer, and in a vast range of diseases 
where acute suffering is the main symptom, we are en- 
abled to give our patients temporary, and sometimes per- 
manent, relief. So great, indeed, is the popularity of this 
mode of treatment, that a new school of opium-eating, so 
to speak, has been formed, and morphia-injections have 
unfortunately been practised to a great extent as a mere 
development of self-indulgence. We must, of course, be 



OPIUM. .279 

very careful not to give even the most casual or indirect 
encouragement to such disastrous habits. 

Some caution is always requisite in prescribing these in- 
jections for the first time, as not only severe sickness and 
vomiting have followed their use in many cases, but great 
prostration, with failure of the heart's action, and even 
death. We must therefore carefully watch our patient 
for some time after the completion of the little operation. 
We must never begin with a larger quantity than the sixth 
of a grain : and we are told, on good authority, that the 
combination of ^ of atropia to one part of morphia will 
effectually obviate all risk of these unpleasant consequences. 
For injection we may use either the injectio morphise hypo- 
dermica [Br.], containing 1 gr. of the acetate in every 12 
minims, or the elegant and convenient gelatine disks pre- 
pared by Messrs. Savory and Moore at the suggestion of 
Dr. Sansom, remembering that morphia acts in this way 
three times more powerfully than when taken by the mouth. 
For internal use we may prescribe either salt, remember- 
ing, however, the varying susceptibilities of different per- 
sons, and the fact that so small a quantity as half a grain 
has caused death ; or we shall find the liquor morphiae 
hydrochloratis [Br.] or acetatis [Br.], containing half a 
grain to the drachm, a convenient preparation. 

Most of the other alkaloids contained in opium are 
merely subjects for physiological curiosity. 

1. Codeia, however, is now frequently used, not for 
its narcotic properties, which are feeble and transient, but 
for an undoubted soothing influence which it exerts over 
various painful affections of the kidney. It is also an es- 
tablished remedy in cases of diabetes, checking the secre- 
tion of sugar, and arresting, in some measure, the progress 
of the disease. Dose 1 to 3 grs. 

2. Narceia possesses only one-eighth of the narcotic 
properties of morphia, and is never used in medicine. 

3. Cryptopia is one-fourth as powerful as morphia, and 
in addition to its hypnotic properties it causes in the lower 
animals peculiar illusions of vision, with a tendency to 
convulsive action. It also is never used. 

4. [Paramorphia or] Thebaia is purely excitant, and 
in doses of 1 grain it causes tetanic spasms. 

5. Narcotina has no narcotic properties, but has some 
power as an antiperiodic. 

6. Papaverine is narcotic. 



280 PAREIRA BRAVA. 

7. Meconine is feebly narcotic. 

8. Apomorphia is a powerful emetic, generally used by 
subcutaneous injection, in doses of - r l F gr. 



[ORIGANUM— COMMON MARJORAM. 

The herb of Origanum vulgare, U. S. 

Officinal Preparation. 

Oleum Origani. Dose, gtt. ij.-v. 

The oil of origanum is rarely used, being largely super- 
seded in commerce by the oil of thyme. It is an aromatic 
stimulant. Origanum in infusion has been used as a dia- 
phoretic and emmenagogue, and externally as a fomenta- 
tion.] 



[OS— BONE. 

Introduced as the source of Calcii Phosphas Prsecipitata 
and Sodii Phosphas.] 



OVUM— EGG. 

\_The egg of Phasanius G alius, U. S. 

Used in pharmacy in making emulsions, and is an ingre- 
dient in Mistura Chloroformi.] 

White of egg is of use as an antidote to various conosive 
poisons, as perchloride of mercury, and the yolk (vitellus) 
has nutritive properties. 



[PAPA VER— POPPY CAPSULES. 

The nearly ripe capsules of Papaver somniferum, U. S. 

Occasionally, though rarely, employed in decoction or 
cataplasm; and the Syrupus Papaveris (Br.) is sometimes 
given to children, but is an uncertain preparation.] 



PAREIRA— PAREIRA BRAVA. 

[ The root of Cissampelos Pareira, U. S. 

Officinal Preparations. 

Extractum Pareirse Fluidum. Dose, fjss.-j. 
Infusum Pareirae. Dose, foj.-ij.] 



PHOSPHORUS. 



281 



Local Action. 
Pareira has no local action. 

Constitutional Actions. 



Therapeutical. 

Pareira is used iri various 
chronic bladder - affections, 
but it seems to be very un- 
certain in its action. 



Physiological 

Digestive and Secreting 
Organs. — Pareira acts in 
some measure as a diuretic, 
but its main influence is di- 
rected to the bladder, which 
it appears to stimulate and 
strengthen, improving the 
tone of its mucous lining, 
and lessening abnormal se- 
cretions. — — — 

[PEPO— PUMPKIN SEEDS. 

The seeds of Cucurbita Pepo, U. S. 

Pumpkin-seeds are an efficient taenicide in doses of one 
or two ounces. The decorticated seeds, beaten into a 
paste with sugar or milk, are given in the morning fasting, 
followed, in an hour or two, by a dose of castor oil.] 



PHOSPHORUS—PHOSPHORUS. 
Dose, in substance, gr. ^ to ^. 

Antidotes. 
There is no direct antidote, but turpentine is said to act 
as a prophylactic. [Old oil of turpentine is considered 
an antidote to phosphorus, followed by demulcents and 
evacuants.] 

(Phosphorus is not used externally.) 

Physiological Action. Therapeutical Action. 

1. Its action on the nerv- 1. Phosphorus is therefore 
ous system is tonic and stim- a valuable agent in nervous 



ulant, repairing the waste of 
tissue. 



debility, where the brain is 
weakened by anxiety, worry, 
overwork, or sexual excess- 
es, and where too great 
amount of phosphates is ex- 
creted by the urine ; and 



24^ 



282 



PHOSPHORUS. 



2. On the circulation it 
acts in the first place as a 
stimulant ; the pulse rises 
and gains in fulness but not 
firmness, the face flushes, 
and eventually signs of peri- 
pheric capillary expansion 
ensue, ending in free perspi- 
ration . In large doses, how- 
ever, it depresses to a dan- 
gerous degree the heart's 
action. 

3. The temperature dur- 
ing the administration of 
phosphorus at first rises 
slightly, next becomes sec- 
ondarily lowered by three 
or four degrees in conse- 
quence of the dilatation of 
the superficial capillaries and 
resulting evaporation from 
the skin. 

4. On the urine phospho- 
rus exerts the following in- 
fluence : Its quantity is 
increased, it becomes red- 
dish, clouded with lithates, 
acquiring a violet smell, and, 
according to B. von Bauer, 
its proportion of urea is 
markedly increased. 



still more markedly in neu- 
ralgia, which has been shown 
by Anstie to depend on a 
feeble state of nerve tissue. 
It is also useful, like arsenic, 
in certain obstinate forms of 
skin disease, as psoriasis, &c. 

Hammond has advised its 
use in the early stages of 
brai?i- softening from over- 
exertion. 

2. Phosphorus may be 
given with decided benefit 
as a stimulant in typhoid con- 
ditions' where great feeble- 
ness exists, and as a general 
tonic it is of marked value, 
the appetite being sharpened 
and a general sensation of 
well-being felt. 



PHOSPHORUS. 



*&S 



Hematuria results from a 
poisonous dose. 

5. On the intestinal secre- 
tion no effect is produced by 
small doses ; but, in the 
event of a large quantity 
being taken, great and per- 
sistent irritation of the 
stomach and intestines re- 
sults, causing pain, vomit- 
ing, and purging. Jaundice 
is also a symptom of its 
poisonous action, and after 
death fatty degeneration of 
the liver is generally found. 

6. To the skin, phospho- 
rus acts in some measure as 
an irritant. 



7. Its effects on the osse- 
ous tissue are remarkable, as 
it has the property of causing 
necrosis of the jaw-bone, and 
this used to be common in 
lucifer-match makers. Some 
interesting experiments by 
Wegner have recently shown 
a marked influence of phos- 
phorus in promoting the 
formation of bone ; for 
when given to growing 
animals the cancellous tissue 
was rapidly transformed into 
hard bone, and, even in the 
case of those fully develop- 
ed, the medullary canal was 



5. Much discussion has 
recently arisen respecting 
the remedial powers of 
phosphorus in leucocythcemia 
and pernicious ancemia, but 
the evidence is too conflict- 
ing to enable us to come to 
any decided opinion at 
present. The remedy is 
well worth trying, however, 
in these otherwise desperate 
cases, and Broadbent has 
recorded one remarkable 
success. 

6. On this account, and 
also because of its stimulat- 
ing the cutaneous circula- 
tion, phosphorus has been 
given with success in the 
eruptive fevers, such as 
scarlet fever, measles, &c, 
to develop an insufficiently 
developed, or prematurely 
faded, eruption. 

7. The experiments of 
Wegner would indicate its 
use in rickets. 



284 PHOSPHORUS. 

sensibly diminished by its 
use. Also, in cases of arti- 
ficial fracture, not only was 
the resulting repair more 
rapid, but the quantity of 
bone thrown out was far in 
excess of the usual amount. 

Poisonous Effects. 

These we have seen to consist of intestinal irritation, 
cardiac syncope, and death from exhaustion, the post-mor- 
te?n disclosing fatty and parenchymatous degeneration of 
liver, muscles, and tissues generally. 1^ gr. has proved 
fatal . 

Phosphorus is given out from the system principally 
by the urine, the drug being oxidised in the system and 
eliminated as phosphates. 

CONTRA-INDICATIONS AND DISADVANTAGES. 

We must generally feel our way in prescribing phospho- 
rus, and begin with small doses, for some persons are 
more susceptible than others to its over-action, and Anstie 
records a case in which three or four j4 gr. doses gave 
rise to long-continued epigastric pain. Nor must we for- 
get its tendency to cause fatty degeneration of internal 
organs. 

Mode of Administration and Dose. 

Much of our success, however, in giving phosphorus 
depends on the mode in which it is prescribed, and, as a 
general rule, capsules containing 3^ grain are found to be 
a convenient medium. It also goes well with cod-liver 
oil, but it is very difficult indeed to devise any liquid form- 
ula by which it is prevented from becoming rapidly inert 
by oxidation. Most of the pill-masses are useless from 
being made with insoluble materials which pass through 
the bowels unchanged. 

The dose, speaking generally, is from g\ to ^ grain ; 
or we may give the phosphide of zinc, a very convenient 
and reliable preparation, much praised by Ashburton 
Thompson, [in pills containing] from T 1 ^ to ]4, grain. 



CALABAR BEAN. 285 

ACIDUM PHOSPHORICUM GLACIALE— 
GLACIAL PHOSPHORIC ACID. 

[Officinal Preparation, U. S. 
Acidum Phosphoricum Dilutum. Dose, rrrx.-xl.] 

This acid was formerly held to be of advantage in dia- 
betes, but more recent investigation has shown that instead 
of diminishing it actually tends to increase the amount oi 
sugar given off by the urine. It therefore cannot be held 
to have any special significance from a therapeutic point 
of view, but may be adopted as an agreeable mode of in- 
troducing acid into the system, as its flavor is agreeable. 
We may take occasion, however, to mention a mistake 
which is not uncommonly made in prescribing, and that 
is to prescribe phosphoric acid with the view of obtaining 
the medical influence of phosphorus. Now it is well 
known that only from phosphorus in a free condition do 
we obtain any real benefit, and of this phosphoric acid 
contains no trace. 

[It has, however, been used as a tonic and alterative in 
rickets and scrofula ; and is an excellent adjuvant to 
cough-mixtures, or tonics, for elderly patients.] 



PHYSOSTIGMA— CALABAR BEAN. 

^The seed of Physostigma venenosum (Balfour}, U. S.~\ 

The ordeal bean of Old Calabar. 

[Officinal Preparation. 

Extractum Physostigmatis. Dose, gr. J-J^.] 

Antidotes. 

In addition to the general principles of treating this form 
of poisonous action, we have here physiological remedies 
at command — (i) atropia, which directly antagonises the 
respiratory depression; and possibly (2) strychnia, which 
stimulates the cord. 

Local Actions. 

Physiological. Th erapeutical. 

When applied to the sur- Calabar bean is therefore 
face of the body, Calabar of use in ophthalmic surgery, 



286 



CALABAR BEAN. 



bean exerts no special influ- 
ence, but when introduced 
to the eye it causes very- 
complete contraction of the 
pupil. 



to counteract the dilating 
effect of belladonna, and to 
prevent prolapse of the iris 
in cases of corneal injury or 
ulceration. 



Constitutional Actions. 



1. On Nervous System. — 
i. The brain is quite un- 
affected, the mind, in cases 
of poisoning, remaining 
clear almost to the last. 

2. The spinal cord, how- 
ever, is specially attacked, 
and to a diminution of its 
motor power are due the 
muscular enfeeblement and 
final paralysis which affect 
those brought fully under 
the influence of this drug. 
A still more remarkable 
result, however, is the total 
abolition of all reflex activity, 
the most energetic stimula- 
tion failing to elicit the 
slightest response. 



2. The depressing action 
of Calabar bean on the re- 
flex powers of the spinal 
cord led Fraser to propose 
it as a remedy for tetanus, 
and this mode of treatment 
has proved very satisfactory 
in alleviating the symptoms 
and checking the course of 
this terrible disease. It is 
of great importance that the 
drug should be early used 
and vigorously pushed, as 
there is every reason to be- 
lieve that the cord is free 
from marked pathological 
changes during the first 
period of the disease. 

Calabar bean has been 
tried without success in 
chorea, epilepsy, and other 
nervous disorders ; but 
recently Dr. Crichton 
Browne has expressed his 
conviction, founded on the 
observation of a few cases, 
that it may prove useful in 
the general paralysis of the 
insane. 

It has also been found to 
act as an effective antidote 
in strychniapoisoning. 



CALABAR BEAN. 287 



3. Although, in the first 
stage of Calabar-bean ac- 
tion, the motor nerves are 
unaffected, a secondary les- 
sening of their conductivity 
is noted, and, with reference 
to the sympathetic system, 
an early excitation is fol- 
lowed by a secondary de- 
pression. 

The contraction of the iris 
noted above, which takes 
place equally on local or in- 
ternal administration, is con- 
sidered due to paralysis of 
the peripheral vaso- motor 
nerve fibres, and to stimu- 
lation of the terminal fila- 
ments of the third nerve. 

II. Circulating Appara- 
tus. — Under small doses of 
Calabar bean, the heart's 
action becomes slower and 
stronger, and the arterial 
tension is notably increased ; 
but when the system is 
brought more fully under 
the poisonous influence of 
the drug, the cardiac pulsa- 
tions become feeble and 
irregular, and finally cease. 
These results are believed 
to be due to stimulation and 
subsequent exhaustion of the 
peripheral cardiac filaments 
of the vagi, and the primary 
contraction and subsequent 
relaxation of the arteries are 
explained in the same way. 

III. Respiration and Tem- 
perature. — The breathing 
usually becomes slow and 
irregular, and the tempera- 
ture falls a little. 



288 PILLS. 

IV. Secreting Organs. — 
Calabar bean tends to cause 
vomiting, with violent and 
painful contraction of the 
stomach and increased peri- 
staltic movement of the in- 
testines. 

Increase in the salivary 
and cutaneous secretions has 
also been observed. 

Poisonous Action. Cautions. Mode of 
Administration. 

Calabar bean in small doses destroys life by paralysing 
the respiratory centre and causing suffocation, but in 
larger quantity it proves more speedily fatal by cardiac 
syncope. 

Caution is of course necessary in dealing with so poison- 
ous a substance as this. It is seldom used internally, for in 
tetanus the functions of the stomach are suspended in great 
measure, and drugs are probably only very partially ab- 
sorbed. Subcutaneous injection is therefore our best 
method, and we use a solution of the extract (from \ to 
\ gr.), neutralising its irritating acidity by the addition of a 
little soda. 

The alkaloid eserina [the active principle] is unstable 
and difficult to extract, and is therefore practically useless. 
[The sulphate of eserina is ten times the strength of the 
extract.] 



[Pilulse. 

The officinal Pills are: — 

Pilulse Aloes Pilulse Ferri Iodidi 

" " et Assafoetidse " Galbani Compositse 

" " et Mastiches " Hydrargyri 

" " et Myrrhse " Opii 

" Antimonii Compositse " Quinise Sulphatis 

" Assafoetidse " Rhei 

" Catharticse Compositse " " Compositse 

" Copaibse " Scillse Compositse. 

" Ferri Compositse 

Two Pill-masses are officinal: Pilula Ferri Carbonatis 
and Pilula Saponis Composita.] 



CANADA PITCH. 289 

[PIMENTA— PIMENTO (ALLSPICE). 

The unripe berries of Eugenia Pimenta [De Candolle), U. S. 

Officinal Preparation. 
Oleum Pimentse. Dose, gtt. iij.-vj. 

Pimento is a warm, aromatic stimulant, but is more used 
as a condiment than as a medicine. As a carminative, the 
dose is from ten to forty grains.] 



PIPER— BLACK PEPPER. 

\The unripe berries of Piper nigrum, U. S. 

Officinal Preparation. 
Oleo-resina Piperis. Dose, nrj.] 

Pepper is an acrid stimulant, acting more especially on 
mucous membranes, and hence, as a condiment, it is sup- 
posed to excite the secretion of the gastric juice. In for- 
mer years it also acquired some reputation as a remedy 
for hemorrhoids. [Piperin, not officinal, is sometimes 
added to antiperiodic pills, but probably owes its effects 
to an impurity, the active oil of pepper.] 



PIX BURGUNDICA— BURGUNDY PITCH. 

\_A prepared resinous exudation from Abies excelsa {Lamarck' 's 
Ency. Method), U. S. 

Enters into Emplastrum Antimonii, Emp. Ferri, Emp. 
Galbani Compositum, Emp. Opii, Emp. Picis Burgundicae, 
and Emp. Picis cum Cantharide.] 

Pitch is used externally in the form of plaster. 



[PIX CANADENSIS— CANADAPITCH (HEMLOCK). 

The prepared resinous exudation from Abies Canadensis ( Michaux, 
N. A?n. Silvd), U. S. 

Officinal Preparation. 

Emplastrum Picis Canadensis. 

Used only in the form of the plaster. The oil of the 
Abies, or Pinus, Canadensis, or Hemlock Spruce (oil of 
spruce, oil of hemlock), has been given to produce abor- 
tion. A fluid extract of the bark (Ext. Pinus Canadensis 
fluid.), not officinal, is largely used as an astringent for gar- 
gles, vaginal douches, &c] 

2 5 



290 



TAR 



PIX LIQUIDA— TAR. 

[ The impure turpentine from the wood of Pinus palustris, and of 
other species of Pinus prepared by burning, U. S. 

Officinal Preparations, U. S. 
Glyceritum Picis Liquidae (n^xxx, in fsj.). Dose, 

f3j.-iv. 

Infusum Picis Liquidae (Tar 20 percent.). Dose,foss.-j. 
Unguentum Picis Liquidae (Tar, 50 per cent. ).] 

External Actions. 



Physiologica l. 

Tar acts as a stimulant to 
the skin, and is apt to pro- 
duce an irritable papular 
eruption. It is rapidly ab- 
sorbed, and if allowed to 
remain in contact with the 
surface of the body, or if 
applied over an extensive 
cutaneous area, feverish 
symptoms ensue, with an 
abundant discharge of black- 
ish urine, smelling strongly 
of tar. 



Therapeutical. 

Tar is an excellent appli- 
cation in cases of chronic 
scaly skin disease, as psori- 
asis. 

To lessen the risk of ex- 
citing an undue amount of 
irritation, it is well to wash 
the skin perfectly clean be- 
fore renewing the applica- 
tion, and it is important to 
rub in the ointment tho- 
roughly until it nearly dis- 
appears. 



Internal Actions. 



Tar seems to have a stim- 
ulating action on mucous 
membranes when taken in- 
ternally. [Tar contains a 
certain proportion of crea- 
sote, upon which some of its 
therapeutic effects depend.] 



The vapor of tar used to 
be a remedy of some reputa- 
tion in chronic bronchitis, and 
recently Prof. Ringer has re- 
commended two-grain pills, 
three times a day, as a most 
efficient remedy in winter- 
cough. The internal use of 
tar has also been praised by 
Dr. McCall Anderson in 
chronic skin diseases. [The 
syrup of tar (5j- in f^iv.) 
is not officinal, but may be 
given in advanced bronchitis, 



LEAD. 291 

in half-ounce doses. The 
infusion is stimulant and diu- 
retic.] 



PLUMBUM— LEAD. 

[Officinal Preparations, U. S. 

Plumbi Oxidum (Litharge). 

Emplastrum Plumbi (Lead-plaster). 

Emp. Assafcetidae (Assafcetida plaster). 

Emp. Ferri. 

Emp. Galbani Compositum. 

Emp. Hydrargyri. 

Emp. Opii. 

Emp. Resinas (Adhesive plaster). 

Emp. Aconiti. 

Emp. Arnicae. 

Emp. Belladonnae. 
Emp. Saponis. 

Ceratum Saponis. 

Liquor Plumbi Subacetatis (Goulard's extract). 

Liq. Plumbi Subacetatis Dilutus (lead-water). 

Ceratum Plumbi Subacetatis (Goulard's cerate). 

Linimentum Plumbi Subacetatis. 
Plumbi Acetas (Sugar of lead). Dose, gr. ij.-v. 

Suppositoria Plumbi (each gr. iij.). 

Suppositoria Plumbi et Opii (each gr. iij., and Ext. Opii 
gr. ss.). 

Plumbi Carbonas. 

Unguentum Plumbi Carbonatis (5j- in iij.)- 
Plumbi Nitras (used as a disinfectant — Ledoyen's solu- 
tion). 

Plumbi Iodidum. 

Unguentum Plumbi Iodidi. 

Antidotes. 

Sulphuric acid forms an insoluble compound with lead, 
and, therefore, the soluble sulphates (alum, Epsom salts) 
are chemical antidotes to lead-poisoning; they are often 
given combined with sulphate of morphia to relieve pain 
and relax spasm.] 



292 LEAD. 

Id poisoning by lead, we must give sulphate of magne- 
sia, iodide of potassium, sulphur baths, and remove its 
after-effects by galvanism of the paralysed muscles ; but 
it is stated that sulphuric-acid lemonade, and a liberal 
indulgence in fatty articles of diet, may act in some degree 
as prophylactics. 

Local Actions. 

Physiological. Th erapeutical. 

The external action of Lead, in the form of sub- 
lead is partly sedative and acetate, is much used as a 
partly astringent. [AH the lotion for erysipelas, acute 
preparations of lead are used eczema, and various ulcera- 
externally, but the acetate tive conditions, 
appears to be the only one It forms a good collyrium 
adapted for internal use.] in the more superficial in- 
flammations of the eye; but 
we must remember that its 
tendency to deposition may 
cause a permanent white 
patch in corneal ulcers. 

The powder of nitrate of 
lead has been shown to be a 
good application in onychia 
maligna. 

Internal Actions and Uses. 

1. Brain and Nervous 
System. — When lead is given 
in poisonous doses, a curious 
train of nervous symptoms 
show themselves, beginning 
with violent neuralgic pains 
and giddiness, and running 
on into delirium, with epi- 
leptiform convulsions, and 
subsequent melancholia. 
Sclerosis of the areolar tis- 
sue, with diminution of the 
nervous elements, has been 
found in certain of the 
sympathetic ganglia, but 



LEAD 



293 



more especially the coeliac 
and cervical ganglia. Atro- 
phy of the optic nerve is an 
occasional, though rare, 
complication of lead-poison- 
ing. 

2. Heart and Circulation. 
During the action of lead, 
the heart becomes slow, and 
the pulse smaller and harder, 
indicating a condition of 
contraction and tension of 
the arterial system ; and 
this is by some supposed to 
be due to a primary effect 
on the sympathetic, whilst 
others hold that lead has a 
direct influence over un- 
striped muscular fibre, and 
most powerfully over that 
which encircles the arteries. 
Lead tends to produce pal- 
lor by destroying the red 
blood-corpuscles. 

3. Intestinal Tract. — A 
prominent symptom of 
chronic lead - poisoning is 
obstinate constipation, de- 
pending probably on con- 
traction of the small intes- 
tine, and associated with 
violent colicky pain around 
the umbilicus. The appetite 
at the same time becomes 
bad, the tongue loaded, and 
nausea and even vomiting are 
observed. Gastro-enteritis 
is generally one of the 
symptoms of acute poison- 
ing. 

Urinary System. — Lead 
has the curious property of 
obstructing the elimination 

25 : 



2. This contractile influ- 
ence of lead over the smaller 
vessels explains its action in 
i?iternal hemorrhage, as we 
know that hozmoptysis, more 
especially, may be very 
successfully treated by ace- 
tate of lead in doses of from 
^ gr. to 3 grs. 



3. Acetate of lead is an 
excellent astringent in diar- 
rhoea, more especially that 
of phthisis, and British [or 
sporadic^ cholera. 

Dr. Thorowgood has ob- 
tained good results from 
lead in obstinate obstruction 
of the bowels. 



294 LEAD. 

of uric acid from the blood 
through the kidneys, and 
may thus cause gout in 
painters and others who are 
exposed to the effects of the 
metal. 

Muscular. — Lead causes 
violent pains in the muscles, 
with a peculiar form of 
paralysis affecting the exten- 
sors of the fore-arms, and 
causing the well known 
wrist-drop ; and post-mortem 
we find fatty degeneration 
of the muscular structures. 

The contracting power of 
lead overunstriped muscular 
fibre probably explains the 
tendency to abortion noted 
during its poisonous influ- 
ence. 

Poisonous Effects. 

The first sign of chronic lead-poisoning is a bluish line 
running along the free margin of the gums composed of 
minute dots, and depending on the actual deposition of 
lead in the mucous membrane. To this succeed colic, 
wrist-drop, and the other symptoms mentioned above, the 
post-morten disclosing chronic catarrh of the stomach and 
intestines, with the deposition of the metal in the bones, 
liver, kidney, brain, nervous and muscular tissues. 

Chronic lead-poisoning has occasionally resulted from 
adulterated cider or from water, and indeed in a variety 
of ways, but it is most common in painters, who are 
brought much in contact with the carbonate in the prac- 
tice of their business. 

Mode of Elimination. 

Lead is thrown out of the system by the urine, skin, 
bowels, and milk. 



MAY-APPLE. 



2 95 



Mode of Administration, &c. 

If we wish to administer lead internally, we generally 
prescribe either the acetate or pil. plumbi cum opii [Br.] 
(i gr. of opium in 8), dose, 4 to 8 grs. 

Externally we find the liquor plumbi subacetatis dilutus 
the most convenient form. 



PODOPHYLLUM— MAY-APPLE. 

[ The rhizome of Podophyllum peltatum, U. S. 

Officinal Preparations, U. S. 

Extractum Podophylli. Dose, gr. v.-xv. 
Resina Podophylli (incorrectly called podophyllin). 
Dose, gr. fe-%.\ 

Local Action. 

Podophyllin cannot penetrate the unbroken cuticle, but 
experiment has shown that it exerts its purgative influence 
when applied to a raw surface. 

Constitutional Actions. 



Physiological. 

The only marked physio- 
logical property of this drug 
is that of irritating the 
duodenum and causing a 
profuse flow of watery 
evacuations, largely mixed 
with bile. Some controversy 
has taken place as to whether 
podophyllin can be called 
a cholagogue in virtue of 
any direct stimulation of the 
secreting structures of the 
liver, experimental evidence 
seeming to show that it 
probably acted by contract- 
ing the gall-bladder, and 
thus favoring the expulsion 
of its contents, and by ex- 
citing the duodenum to 
sweep away the bile effused 
into it by the hepatic ducts. 



Th erapeutical. 

Podophyllin is a valuable 
remedy in jaundice and in 
the various forms of func- 
tional liver -affection. It 
may be used in simple 
chronic constipation, in the 
constipation of children 
attended with the painful 
and difficult evacuation of 
hard, dry faeces, and in the 
opposite condition of diar- 
rhoea with pale and frothy 
motions. 

In sick headache it also 
acts well. 

[Podophyllum is an effi- 
cient substitute for jalap, and 
may be used for all pur- 
poses for which the latter 
drug has been recom- 
mended.] 



296 POTASSIUM. 

The more recent experi- 
ments of Rutherford and 
Vignal, however, have re- 
instated podophyllin in its 
old position as a true 
stimulant of the biliary 
secretion. 

Cautions and Mode of Administration. 

We must remember that podophyllin is an uncertain 
drug, acting well in some cases, very slightly in others, 
whilst in a third class it causes much discomfort and grip- 
ing. It is advisable, therefore, always to begin with small 
doses, as ^ gr. or y 2 g r - , and to prescribe it in the form 
of pill, combined with other ingredients which may 
restrain its irritating action. Thus : — 

I£. Resinse podophylli gr. ij. ; 

Extracti belladonnse gr. iij.; 

Pil. colocynthidis compositse gr. xxxvj. M. 
Fiant pilulse duodecim, quarum capiat imam omni nocte. 

Ringer recommends a very convenient way of prescrib- 
ing podophyllin for children, by dissolving a grain in a 
drachm of rectified spirit, and giving 5 or 6 drops three or 
four times a day on a lump of sugar [or painted on a bun]. 



POTASSIUM—POTASSIUM. 

[Officinal Preparations, U. S. 

Potassa. Caustic Potassa. 

Liquor Potassae. Dose, n^x.-xxx. 

Potassa cum Calce (equal parts), used as a caustic. 

Potassii Acetas. Dose, gr. xx.-3j. 

Potassii Carbonas Impura (Pearlash). 

Potassii Carbonas. Dose, gr. x.-xxx. 

(Extractum Spigeliae et Sennae Fluidum, Mistura Ferri 
Composita, Potassii Bicarbonas, Potassii Sulphuretum, 
and in making Chloroformum Purificatum and Spiritus 
./Etheris Nitrosi.) 

Potassii Carbonas Pura. Dose, gr. x.-xxx. 

(Used in making the Bromide and Cyanide, and Mis- 
tura Potassii Citratis.) 

Potassii Bicarbonas. Dose, gr. x.-5j. 



POTASSIUM. 297 

(Liquor Magnesia Citratis, Liquor Potassae, Liquor Po- 
tassii Arsenitis, Liquor Potassii Citratis, Mistura Po- 
tassii Citratis, Potassii Acetas, Potassii Carbonas Pura, 
Potassii Citras.) 

Potassii Bichromas (as an alterative). Dose, gr. J. 
(Used in preparing Sodii Valerianas.) 

Potassii Bitartras (Cream of Tartar). Dose, 5}.-iv. 
Antimonii et Potassii Tartras, Ferri et Potassii Tartras, 
Potassii et Sodii Tartras, Potassii Tartras, Pulvis Ja- 
lapse Compositus. 

Potassii Bromidum. Dose, gr. xx.-3j. 

Potassii Chloras. Dose, gr. v.-xx. 

Trochisci Potassii Chloratis. 
Potassii Citras. Dose, gr. x.-xxx. 

Liquor Potassii Citratis. Dose, f^ss. 

Potassii Cyanidum. Dose, gr. yi. 

Potassii Ferrocyanidum. Dose, gr. x.-xv. 

(Used in making Acidum Hydrocyanicum Dilutum, 
Argenti Cyanidum, Ferri Ferrocyanidum, Hydrargyri 
Cyanidum, Potassii Cyanidum.) 

Potassii Hypophosphis. Dose, gr. x.-xxx. 

Potassii Iodidum. Dose, gr. x.~3j- 

(Ammonii Iodidum, Hydrargyri Iodidum Rubrum, Li- 
quor Iodinii Compositus, Plumbi Iodidum, Tinctura 
Iodinii Composita, Unguenturn Iodinii, Unguentum 
Iodinii Compositum, Unguentum Potassii Iodidi (5j- 
to SJOO 
Potassii Nitras. Dose,' gr. x.-xv. 
Potassii Permanganas. Dose, gr. j.-v. 

Liquor Potassii Permanganatis (gr. iv. to f^j-)* 
Potassii Sulphas. Dose, gr. xx.-Jiv. 

Pulvis Ipecacuanhas Compositus. Dose, gr. x. 

Potassii Sulphis. Dose, gr. xv.-5j. 

Potassii Sulphuretum. Dose, gr. ij.-v. 

Potassii et Sodii Tartras (Rochelle Salt). Dose, §ss.-j. 

Potassii Tartras. Dose, 3J- - 3j- 

Antidotes. 
Vinegar and lemon-juice. 



298 



POTASSIUM. 



Local Actions. 



Physiological. 

Caustic potash is a most 
powerful escharotic, with- 
drawing water from the tis- 
sues, and thus destroying 
them. It has, however, the 
disadvantage of being very- 
deliquescent, and this ten- 
dency to spread, beyond the 
part we wish to attack, has 
led to its practical abandon- 
ment as a local application. 



The permanganate of pot- 
ash, or Condy's fluid, oxi- 
dises and destroys many or- 
ganic substances. 



Therapeutical, 

Caustic potash, either in 
sticks or combined with lime 
in the form of potassae cum 
calce, was formerly used in 
the treatment of various 
forms of ulceration, and for 
the production of issues, 
which barbarous relics of 
antiquity are now fortunately 
discarded from practice. 
Liquor potassae has been re- 
commended to soften the 
great toe-nail and facilitate its 
removal when ingrowing ; 
and the bicarbonate of pot- 
ash forms a good lotion in 
acute eczema, and as an in- 
jection in leucorrhoea, and 
as an application to rheu- 
matic joints. 

It is therefore antiseptic, 
and a good application to 
unhealthy ulcerations. 



Internal Actions and Uses. 



Physiological. 

1 . Brain and Nervous Sys- 
tem. — Potash salts, and more 
especially the nitrate, when 
given in large doses, exert a 
paralysing action on the spi- 
nal cord, producing great 
muscular weakness and final 
abolition of reflex sensibility. 

2. Heart and Circulation. 
Moderate doses of the ni- 
trate raise the arterial tension 
and slow the heart's action, 



Th erapeutica I. 



POTASSIUM. 



2 99 



and if the drug is further 
pushed, the pulsations be- 
come weaker, still slower, 
and finally irregular, before 
the total arrest of movement 
supervenes. 

Potash salts cause the 
blood, and secondarily, the 
urine, to become alkaline, 
and any excess of uric acid 
may thus become neutral- 
ised. 



3 . Intestinal Tract. — Chlo- 
rate of potash moderates ex- 
cessive action of the salivary 
glands, and assists the heal- 
ing of ulceration about the 
gums, mouth, and throat. 
The salts of potash generally 
neutralise free acid in the 
stomach and intestines, and 
the nitrate in full doses may 
cause death by gastro-ente- 
ritis. Most of the potash 
salts are slightly purgative, 
but only the acid tartrate has 
any very decided action of 
this kind, causing as it does 
the abstraction of a large 
quantity of watery fluid, 
without, however, stimulat- 



2. This has been supposed 
to explain the beneficial ac- 
tion of potash in acute rheu- 
matism, which is held to de- 
pend on an excess of uric 
acid. Much controversy has 
taken place with reference to 
the alkaline treatment of this 
disease, but I am decidedly 
of opinion that if large doses 
of bicarbonate of potash do 
not shorten its duration, they 
relieve symptoms, and lessen 
the tendency to cardiac com- 
plications. Potash acts well 
also in gout and chronic rheu- 
matism by forming a soluble 
salt with uric acid. 

3. Chlorate of potash, in 
doses of from 5 to 20 grains, 
is an admirable remedy in 
{true croup\ mercurial sali- 
vation, in various aphthous 
conditions, and in sore 
throat, whether produced 
by scarlet fever or ordinary 
tonsillar inflammation, and 
a wash or gargle may well be 
combined with its internal 
administration. 

In doses of from 120 to 
300 grains, cream of tartar 
is a good purgative, but is 
principally used in combi- 
nation with jalap, which, by 
stimulating the muscular 
movements of the small in- 



3°° 



POTASSIUM. 



ing the peristaltic movement 
of the intestines. The sul- 
phate is also aperient in its 
action. 

4. On Secreting Organs. — 
It will be remembered that, 
in speaking of acids, we re • 
ferred to a law which has 
been more especially devel- 
oped by Ringer, and which 
explains their power of 
checking acid secretions. 
Alkalies have precisely the 
opposite effect, arresting the 
activity of glands furnishing 
alkaline fluids, whilst they 
directly stimulate those 
whose secretion partakes of 
the opposite character. 



Kidneys. — Most of the 
salts of potash, but more 
especially the acetate, ni- 
trate, citrate, and acid tar- 
trate, are diuretic, and the 
acetate, bicarbonate, and ci- 
trate, being converted into 
carbonate, speedily render 
the urine ^alkaline. Elabo- 
rate experiments have been 
made on the more precise 
alterations effected in the 
urine by the salts of potash. 
Prof. Parkes tells us that 
liquor potassse increases the 
destructive metamorphosis 
of the nitrogenous tissues, 
and their elimination as urea, 
as well as that of the sulphur 
in the form of sulphates. 
The acetate has been shown 



testines, prevents the proba- 
ble reabsorption of the wa- 
tery fluid. 

4. We can therefore read- 
ily explain, on physiological 
principles, why alkalies are 
so useful in hepatic conges- 
tion, why they may also stim- 
ulate the pancreatic secre- 
tion, and why their action is 
so beneficial in cases of dys- 
pepsia depending on defi- 
cient supplies of gastric 
juice. On these principles, 
also, we may readily under- 
stand the very striking power 
possessed by a weak solution 
of potash in arresting the 
alkaline secretion so freely 
poured out by the skin in 
acute eczema. 

Potash salts are therefore 
good diuretics in heart dis- 
ease, chronic kidney affec- 
tions, and various dropsical 
accumulations; and their ac- 
tion is much more marked 
under these conditions than 
when administered to healthy 
subjects, since we have seen 
that the acetate, which is 
perhaps the most active of 
the diuretic group, may even 
check the elimination of wa- 
ter from the kidneys during 
health. Dr. Roberts, of 
Manchester, has proposed to 
dissolve uric acid calculi by 
keeping the urine alkaline 
for months with citrate of 
potash. 



POTASSIUM. 30I 

to diminish the water, urea, 
and earthy salts ; whereas 
the citrate, according to Dr. 
Nunneley, increases the wa- 
ter, but diminishes the urea 
and solids. 

Potash may be used under other conditions. Thus in 
asthma the inhalation of the fumes from burnt blotting- 
paper soaked in a strong solution of nitrate of potash is 
often effectual , chlorate of potash is a useful ingredient 
in a cough linctus; the citrate is an agreeable febrifuge, 
and is valuable in many of the feverish and dyspeptic 
affections of children. 

Scurvy is held by some to be dependent on a deficiency 
of potash salts in the blood. 

Poisonous Action. 

Partly from depression of the heart and partly from 
inflammation of stomach and intestines. 

Mode of Elimination. 

The potash salts, having a high diffusive power, pass 
readily into the blood, and are given out by the urine, in 
which the nitrate, chlorate, and sulphate reappear un- 
changed. 

R. Liquoris potassae f 5U- > 

Tincturae calumbse f 31J. ; 

Infusi calumbse f§ v j- M. 

Fiat mist, f §j. ter in die. 

Antacid mixture. 

R. Potass i i bicarbonatis 5J- > 

Potassii acetatis gr. xv. ; 

Potassii nitratis gr. x. ; 

Aquse f^ij- M. 

Fiat haustus quartis horis sumend. 

This constitutes the " full alkaline" treatment recom- 
mended by Dickinson for acute rheumatism, and may be 
prescribed in effervescence. 

[R. Potassii chloratis S l i> 

Syrupi limonis 1 ^j . ; 

Aquae f^iij- M. 

Dose, according to the age of the child : if under two 
years f5j-> from two to ten f3ij-> over ten f^ss., given 
26 



302 BICHROMATE OF POTASSIUM. 

every three hours, or every half hour in urgent cases. 
Recommended as almost specific in diphtheritic croup by 
Dr. T. M. Drysdale, of Philadelphia. 1 ] 

R. Potassii chloratis gj. ; 

Aquae fgvj. M. 

S. f §j. ter die. 

In ulcerated mouth or gums, or mercurial salivation. 

R. Potassii bicarbonatis 5ss. ; 

Aquae Qj. M. 

A good lotion in acute eczema. 

R. Potassii acetatis 3Jss. ; 

Aceti scillae f £iv. ; 

Decocti scoparii [Br.] ad f§vj. M. 

Fiat mist. Dose, f §j. quartis horis. 

Diuretic mixture. 

R. Spiritus aetheris nitrosi f 3U- 5 

Potassii nitratis gr. xx. ; 

Decocti scoparii [Br.] f §iv. M. 
Fiat mist. Dose, f §j. ter die. 
Diuretic. 

R. Potassii [bi-]tartratis 3 l 'j- j 

Succi scoparii [Br.] 5 v j- '■> 

Aquae t|vj. M. 

Dose, f §j. ter die. 
Diuretic. 

R. Potassii chloratis gr. xl. ; 

Glycerini f §ss. ; 

Morphiae hydrochlorat. [muriat.] gr. jss. ; 

Syrupi ad f§iv. M. 

S. f 3J. prout res poscit. 

Dr. Douglas Powell's linctus for the chronic throat 
irritation of consumptive patients. 

[Potassii bichromas. 
Bichromate of potassium, in powder or strong solution, 
is a good escharotic and antiseptic application to warts, 
and venereal excrescences. It has been used internally in 
secondary syphilis, as an alterative, given in pill-form, with 
some bitter extract. Occasionally it produces salivation. 
It acts as an emetic in doses of % gr. In large doses it 
is an irritant, corrosive poison. Antidotes, soap, mag- 
nesia, and bicarbonate of sodium.] 

1 [Phila. Med. and Surg. Rep., March, 1877, vol. xxxvi. p. 238.] 



BROMIDE OF POTASSIUM, 



3°3 



Potassii Bromidum. 

(Bromide of Potassium is not used externally.) 



Physiological Action. 

i. On Nervoics Function. 
Long continuance in the use 
of pot. bromid. tends to 
cause a sense of fatigue and 
general muscular prostra- 
tion, with giddiness and 
staggering. 

Brain. — The functions of 
the brain are lessened, and 
sleep results. [Observation 
has shown that the bromides 
actually reduce the amount 
of blood in the brain.] 

Spinal Cord. — It has been 
proved by experiments on 
animals that the reflex irri- 
tability of the cord is less- 
ened, as indicated by the 
anaesthetic effect which is 
produced on the palate. 

It has also been observed 
that the power of voluntary 
movement persists after the 
abolition of reflex function, 
proving that the influence of 
the drug is exerted probably 
either upon the different 
nerves or upon those por- 
tions of the cord which- 
transmit the impulse from 
these nerves to the cells 
presiding immediately over 
motion. 

Sympathetic System. — Pot. 
bromid. is supposed to have 
a sedative influence over 
the sympathetic system of 
nerves ; but on this point 
the evidence is very contra- 
dictory. 



Therapeutical Actioii. 

i. Pot. bromid. has gained 
great repute within the last 
few years in the treatment 
of a large series of convulsive 
and spasmodic affections, 
and most especially in epi- 
lepsy, it being now thorough- 
ly established that if we get 
our case sufficiently early 
we may absolutely cure it, 
and even if it is too con- 
firmed for this result we may 
keep it in check. The cases 
most under the influence of 
the drug are those known as 
the hant mal, where violent 
struggling is followed by 
comatose sleep ; on the other 
hand, in the petit mal, where 
the attack is indicated merely 
by passing unconsciousness, 
or when the seizures occur 
principally at night, the 
remedy will frequently dis- 
appoint us. 

Pot. bromid. is believed to 
act in epilepsy by relieving 
the spasmodic contraction of 
a vessel supplying a special 
vascular brain area which is 
thus deranged in function. 

It is also of great benefit 
in the various convulsive 
seizures of children, in la- 
ryngismus stridulus, night 
terrors, and also in those 
spasmodic symptoms which 
depend on meningitis or or- 
ganic brain disease. 



3°4 



POTASSIUM. 



2. Effects on Circulation, 
— No special action on the 
heart has been observed save 
some slight lowering of its 
action. The smaller arteries 
have been said to be con- 
tracted, the pulse becoming 
smaller ; and we may thus 
explain the hypnotic action 
of the drug, the brain being 
rendered anaemic as in phy- 
siological sleep. 

3. Its influence on diges- 
tion is not marked ; for 
although it sometimes seems 
to lessen the appetite, this is 
not a constant result. 

4. The effects on the uri- 
nary secretion have not been 
thoroughly made out. 

5. Bromide of potassium 
has an undoubted influence 
over the generative organs, 
lowering their excitability, 
and even in large doses sus- 
pending their action. 



It is of service in incon- 
tinence of urine, pertussis, 
cramp of lower limbs, cho- 
rea, in delirium tre??iens, and 
in many of those forms of 
mental depression, nervous 
headache, and vague sensa- 
tions, indicating nervous 
disturbance, which are so 
distressing to some women 
about the change of life. 

It is said to be a good 
remedy in sea-sickness, from 
the sedative effect on the 
centre concerned in the re- 
flex act of vomiting. 

2. Bromide of potassium 
is an excellent narcotic, and 
causes refreshing sleep, more 
especially in cases of worry, 
mental anxiety,or overwork, 
a full dose being given at 
bedtime; and in acute mania 
its use in combination with 
chloral is highly praised by 
Clouston. 



4. It has been much prais- 
ed by Begbie in diabetes. 

5 . It is useful in priapism, 
and in those forms of Menor- 
rhagia which depend on ova- 
rian irritability. 



IODIDE OF POTASSIUM. 305 

Potassium bromide is eliminated from the system by the 
urine, breath, sweat, and milk (a case being recorded in 
which the child of a suckling mother taking this salt became 
covered with acne). 

Disadvantages and Contra-indications. 

We have already noted the peculiar nervous symptoms 
occasionally caused by pot. bromid. — giddiness, general 
muscular fatigue, even amounting to actual staggering in 
some cases. But in addition to this an unpleasant erup- 
tion of acne often breaks out on the face, and may arise 
from a very small dose. If, in spite of this, the remedy 
is persisted in, the whole body may eventually be covered 
with large and unsightly blotches. 

Dose and Mode of Administration. 

The dose for epilepsy ranges from 10 to 60 grains, it 
being necessary to increase the quantity gradually, and 
continue its use for long periods, even years, occasionally 
leaving it off for a week or so, after which it seems to regain 
some of its lost effect. 

Dose as a hypnotic gr. xx. ad xxx. In other cases 
about gr. xx. as an average. Children bear it well, and 
we may give a child 2 or 3 gr. with good effect. As its 
taste is rather nauseous, we must disguise it, thus : — 

ty. Potassii bromidi gr. xxx. ; 

Syrupi aurantii f£j. ; 

Aquae aurantii flori ad f§ij. 

Fiat haustus hora somni sumendus 

[Or give it simply dissolved in water.] 

[Potassii lodidum — Iodide of Potassium.] 

Constitutional Action. 

Physiological. Therapeutical. 

t. On Brain and Nervous 1. Iodide of potassium is 

System. — No special action of great service in many 

on the nervous system has brain-diseases, and most es- 

been observed, unless we pecially those in connection 

hold that the uncomfortable with tertiary syphilis, where 

sensations of misery and de- gummata, and other forms of 

pression occasionally fol- tumor, cause those excruciat- 

26* 



306 



IODIDE OF POTASSIUM. 



lowing its use may be thus 
explained. 



2. The effects of iodine on 
the circulation have never 
been properly estimated, but 
some observers say that it 
tends to contract the vessels 
and cause increased rapidity 
of the heart's action. Potas- 
sic iodide has very swift dif- 
fusive power, entering the 
blood very rapidly, being 
given off within ten minutes 
after ingestion. 

3. On respiration and tem- 
perature no effects have been 
noted. 

4. Effects on secretion. 

a. Intestinal. — Nothing 
special save occasional 
loss of appetite and dis- 
ordered digestion. 

|3. U?inary. — Potassic io- 
dide has some diuretic 
action, more especially 
in connection with other 
drugs. 

y. The salivary secretion is 
often markedly increas- 
ed, true salivation being 
sometimes produced. 

5. It is also believed that 
the iodide of potassium 
has some special action 
on glandular tissues in 
general, increasing their 
absorptive powers, and 
even exciting them to 
absorb themselves; and 



ing pains and varying nerv- 
ous phenomena which have 
been so ably described by 
Drs. Broadbent and Buz- 
zard. 

2. Potassic iodide has been 
used with great benefit by 
Dr. Balfour and others in 
aortic aneurism, several suc- 
cessful cases having been re- 
ported. It is difficult to 
explain the raiio?iale of its 
action, but it is essential that 
large doses (twenty grains) 
[ter in die] be prescribed 
and continued regularly for 
a year or more. 



/3. Potassic iodide is oc- 
casionally used to heighten 
the diuretic action of other 
drugs. 



8. The iodide of potas- 
sium is often given to facili- 
tate and hasten the absorp- 
tion of inflammatory lymph 
in the later stages of pleu- 
risy, pneumonia, pericardi- 
tis, &c. 



IODIDE OF POTASSIUM. 



3°7 



in support of this last 
proposition it has been 
stated that, under its use, 
the mammae and testi- 
cles have been observed 
to waste and disappear. 
This conclusion has 
probably been arrived 
at, however, by confus- 
ing the post with the 
propter hoc, and it is 
probable that the re- 
medy does not so much 
actually stimulate the 
absorbents as reduce 
effused lymph to a con- 
dition more favorable 
for elimination. 
5. It also has the power of 
removing various metallic 
substances from the tissues, 
— mercury and lead, for in- 
stance, being occasionally 
deposited in the form of an 
insoluble albuminate, and 
released from this condition 
by the action of the drug. 



6. Finally, this salt has an 
irritating action on mucous 
membranes, causing redness, 
tingling, and free secretion, 
resembling much an ordi- 
nary catarrh, and also thin- 
ning and liquefying tena- 
cious, pathological, mucoid 
secretions. 



5. In [cases of] chronic 
leadpoisoning, so often met 
in house-painters, or [where 
we wish] to remove mercury 
from the system, we gene- 
rally prescribe potassic io- 
dide, and in the latter case 
we must not be surprised if 
our patient is suddenly seiz- 
ed with profuse salivation. 
This is explained by the re- 
leased mercury finding its 
way back into the circula- 
tion, and exerting its usual 
influence on the salivary 
glands. 

6. Potassic iodide is often 
prescribed in cases of bron- 
chitis where the expectora- 
tion is thick, tenacious, and 
difficult of expulsion, and it 
here acts well by thinning 
the sputa. 



3 o8 



IODIDE OF POTASSIUM 



7. There are other impor- 
tant uses of potassic iodide 
which cannot be arranged 
tinder the preceding catego- 
ries, and which must there- 
fore be called specific. These 
are its influence over syphi- 
lis, gout, chronic rheuma- 
tism, and simple periostitis. 



7. In cases of tertiary 
syphilis, this salt often acts 
like a charm. In the primary 
and secondary forms, it is of 
little or no use, but when the 
deeper tissues begin to be af- 
fected, and when we meet 
with deep rupial or other 
ulcerations of the skin, ulcers 
in the throat, periostitis, and 
head symptoms, we may then 
prescribe iodine with the 
certain expectation of relief. 
In chronic gout it is also of 
service, and in chronic rheu- 
matism, more especially in 
those cases where we meet 
with tenderness to pressure 
and nocturnal increase of 
pain. In simple periostitis 
of the head, sternum, or 
tibia, which often results 
from exposure to cold, io- 
dide of potassium has an 
almost magical effect, and 
will often bring about a cure 
after two or three days' 
treatment. 



Potassic iodide is eliminated from the body by the urine, 
saliva, tears, milk, &c. ; it can be detected in the urine in 
ten minutes after being swallowed, and it is rapidly given 
out, so that the whole may be recovered from the various 
secretions. 

Disadvantages and Contra-indications. 

As regards its disadvantages and contra-indications, we 
must remember the possible occurrence of iodism, to 
which unpleasant symptom some persons are much more 
susceptible than others. These consist, in the first place, 
of irritation about the mucous membranes, running at the 
eyes and nose, sneezing, frontal headache, swelling of the 
eyes, and salivation; an eruption not unlike nettle-rash is 



IODIDE OF POTASSIUM. 309 

sometimes observed ; occasionally acne may be the result, 
and Ringer has described a peculiar petechial eruption 
affecting the legs. Quite recently Mr. J. Hutchinson has 
expressed his belief that the formidable pustular eruption 
known as hydroa is really caused by iodide of potassium, 
but in my own experience and that of others who have 
freely prescribed the drug, these various uncomfortable 
effects are comparatively seldom observed, a curious point 
being that iodism seems to be much more readily excited 
by small than by large doses of the drug. 

In some persons a good deal of depression and digestive 
derangement is caused. 

Antidote [to Iodism]. 

Some few years ago, Sir James Paget observed that the 
addition of spiritus ammonise aromat. to potassic iodide 
not only lessened the chances of iodism, but enabled us to 
limit ourselves to a smaller dose, and this has come very 
generally into use. 

Dose, and Mode of Administration. 

[The iodide of potassium should be prescribed alone, or 
only in combination with other preparations of iodine, or 
with corrosive sublimate. See note, page 26. 

This salt may be given simply dissolved in water, or its 
taste may be well disguised by administering it in combi- 
nation with compound syrup of sarsaparilla, or compound 
infusion of gentian.] 

Potassic iodide as an anti-syphilitic [maybe given in 
doses of] from 3 to 30 grains, or even 60, according to 
the judgment of prescribers, it being necessary in obstinate 
cases to push the drug very freely. 

[Dr. Taylor, at the meeting of the American Dermatolo- 
gical Association held recently (Sept. 4-6) at Niagara Falls, 
said that patients would tolerate an ounce and a half daily 
and grow fat on it, the only physiological result being 
increased urination. He mentioned a case of nodes, where 
fourteen drachms daily were administered ; nothing less 
would give the patient relief at night. He thought that in 
similar cases the addition of bromide of potassium, one 
drachm to seven of the iodide, would be of advantage. 

He also remarked that he had observed pains in the 
joints occasionally, even when small doses of iodide were 



310 WILD -CHERRY BARK. 

being administered, which were considered as being 
due to the remedies employed. He offered a practical 
suggestion in reference to the prevention of these pains 
(which are diurnal and not nocturnal), which was that 
tincture of colchicum and tincture of hyoscyamus, com- 
bined with small doses of the iodide of potassium, would 
obviate them. Occasionally it is necessary to use cam- 
phorated oil, or some warming application externally. 
The joint trouble is sometimes poly-articular, sometimes 
mon -articular.] 

Professor Syme, however, used to say that all good 
effects can be obtained by two or three grains, and in ordi- 
nary cases of syphilis or periostitis, rheumatism, &c, this 
will [in his opinion] be found a sufficient dose, copious 
dilution aiding its effects. 

In aneurism we must give at least twenty grains, and in 
advanced syphilitic affections even larger doses are well 
borne. 

JjL. Potassii iodidi gr. xl. ; 

Spiritus ammonii aromatici f§ss. ; 

Syrupi aurantii f §j. ; 

L'ecocti sarsaparilloe compositi ad l^viij. M. 
S. Capiat unciam unam ter in die. 



PR17NUM— PRUNES. 

[ The dried 'fruit of Primus domestica, U. S. 

Enters into Confectio Sennae.] Prunes are slightly pur- 
gative. 



[PRUNUS VIRGINIANA— WILD CHERRY. 

The bark of Cerastes Serotina (De Candolle), U. S. 

Officinal Preparations, U. S. 

Extractum Pruni Virginianae Fluidum. Dose, fjj. 
Infus am Pruni Virginianae. Dose, f^ij.-iij. 
Syrupus Pruni Virginianae. Dose, fsss. 

Wild-cherry bark is tonic and sedative, the preparations 
containing a small amount of hydrocyanic acid. The 
syrup, from its pleasant flavor, is much used as an ingre- 
dient in cough syrups for phthisis or chronic bronchitis.'] 



POMEGRANATE — QUASSIA, 



3 11 



[Pulveres. 
The officinal Powders are : — 

Pulveres Effervescentes. — Soda or effervescing powders. 
" " Aperientes. — Seidlitz powders. 

Pulvis Aloes et Canellse. — Hiera Picra (holy bitter). 

" Aromaticus. — Spice powder. 

" Ipecacuanhas Compositus. — Dover's powder. 

" Jalapae Compositus. — Jalap and cream of tartar. 

" Rhei Compositus. — Rhubarb, magnesia, and ginger.] 



PUNICA GRANATUM- 

[Granati Fructus Cortex. 
Punic a Granaium, U. S. 
Granati Radicis Cortex. 

Punica Granatum, U. S^\ 



-POMEGRANATE. 
The rind of the fruit of 

The bark of the root of 



Physio logic a I A ction . 

Pomegranate bark de- 
stroys a tape-worm, accord- 
ing to Kiichenmeister, in 
three hours. [Contains 
gallo-tannic acid, and may 
be used in decoction (^ij. 
to Oj.) as an astringent 
wash.] 



Therapeutical. 
It is much used as an 
anthelmintic in veterinary 
practice [and is sometimes 
given in infusion as a gargle, 
and as an injection in gonor- 
rhoea^. 



QUASSIA— QUASSIA. 

\_The wood of Simaruba exceha, U. S. 

Officinal Preparations, U. S. 

Extractum Quassise. Dose, gr. j.-iij. 
Infusum Quassise (3ij. to Oj.). Dose f^j.-ij. 
Tinctura Quassise (3j. to Oj.). Dose, gtt. xx.-f3j.] 



Physiological Actions. 

The action of quassia is 
directed to the gastro- 
intestinal mucous mem- 
brane, and it is probable 
that its intensely bitter taste 
may stimulate the secretion 
of gastric juice, as it certainly 
increases the appetite. 



llierapeutical Actions. 

Quassia is much used as a 
tonic in dyspepsia, want of 
appetite, and general debil- 
ity. Having no aromatic 
flavor, it is sometimes badly 
borne by weak stomachs, 
but, being very cheap, it is 
largely prescribed in dis- 



312 OAK RESIN. 

pensary practice, more 

especially in combination 

with iron. 

Quassia is destructive to It is therefore of service, 

many of the lower forms of given as an enema, for the 

animal life. destruction oitliread-worms. 



QUERCUS— OAK. 

[Quercus Alba. The inner bark of Quercus alba, U.S. 
Quercus Tinctoria. The inner bark of Quercus tine- 
tor ia, U. S. 

Officinal Preparation, U. S. 

Decoctum Quercus Alba (§j. to Oj.). Dose, fsiv.] 

Oak bark contains tannic and gallic acids, and is there- 
fore of some value as a topical astringent in relaxed throat, 
leucorrhcea, &c. 



[RESINA— RESIN. 

The residue afler the distillation of the volatile oil from the turpentine 
of Pinns palustris, and of other species of Pinus, U. S. 

Enters into Ceratum Cantharidis, Ceratum Extracti 
Cantharidis, Ceratum Resinse, Ceratum Sabinse, Ceratum 
Resinse Compositum, Emplastrum Hydrargyri, and 
Emplastrum Resinse. 

Has no therapeutic interest.] 



[Resinse. 

The officinal Resins are : — 

Resin a Jal apse Resina Scammonii.] 

" Podophylli 



[Oleo-resinae. 

The officinal Oleo-resins are : — 

Oleo-resina Capsici Oleo-resina Lupulinoe 

" Cubebse - " Piperis 

" Filicis " Zingiberis.] 



RHUBARB 



313 



RHEUM— RHUBARB. 

[ The root of Rheum palmatum, and of other species of Rhetim, from 
China, Chinese Tartary, and Thibet, U. S. 

Officinal Preparations, U. S. 

Extractum Rhei. Dose, gr. x.-xxx. 

Extractum Rhei Fluidum. Dose, gtt. x.-xxv. 

Infusum Rhei (3iv. to Oj.). Dose, fgij.-iv. 

Pilulae Rhei (each, gr. iij.). Dose, 4 to 8 pills. 

Pilulse Rhei Compositae (Rhei gr. ij., Aloes gr 
Dose, 2 to 4 pills. 

f Rhubarb jfiv. ") 

Pulvis Rhei Compositus -< Magnesia ^xij 

(Ginger gij. 

Syrupus Rhei (^iss. to Oj.). Dose, f^ss.-j. 

Syrupus Rhei Aromaticus (3ijf to Oj.) 
infant, f3j. 

Tinctura Rhei (^iss. to Oj.). Dose, fsss.-j. 

Tinctura Rhei et Sennae (E}i to Oj.). Dose, f^ss.-j 

Vinum Rhei (^ij. to Oj.). Dose, f3j.-iv.] 

Constitutional Action. 



iss.). 

Dose, 
3ss.-j. 



Dose, for 



Physiological. 

Like castor oil, rhubarb 
combines some astringent 
properties with its undoubt- 
ed cathartic effects ; and 
whilst the first [mentioned] 
action is no doubt due to the 
tannin which it contains, in- 
vestigators have not yet de- 
termined on what special 
ingredient its purgative pow- 
ers depend. 

When taken in consider- 
able doses, it not only stim- 
ulates the peristaltic move- 
ments of the small intestine, 
and more especially the du- 
odenum, but it moistens and 
softens the faeces, and in- 
creases most decidedly the 
secretion of bile. 



Therapeutical. 

The astringent action of 
rhubarb renders it most use- 
ful in those forms of diar- 
rhoea depending on the pre- 
sence of indigestible matters 
in the alimentary canal, and 
where removal of the excit- 
ing cause, followed by rest 
of the irritated intestine, is 
sufficient to effect a cure. 

It is a good tonic in some 
cases of dyspepsia, and forms 
a good purgative for chil- 
dren, more especially when 
combined with magnesia, as 
in the well-known Gregory's 
Powder [Pulv. rhei coinp.]. 

Prof. Rutherford's expe- 
riments on its cholagogue 
action would indicate its 



3 J 4 ROSE. 

employment in jaundice and 
deficient secretion of bile. 

The chrysophanic acid, or yellow coloring matter of 
rhubarb, is readily absorbed, and rapidly given out by 
the intestines, milk, sweat, and urine, to which latter se- 
cretion it imparts a yellow tinge, turning red on the addi- 
tion of an alkali. 

Dose, Mode of Administration, &c. 

The smell and flavor of rhubarb are excessively nauseous, 
and, although we cannot effectually disguise either, we 
may at least render the drug moderately palatable by the 
following formulae: — 

fy.. Infusi rhei f §ij. ; 

Potassii bicarb. 5J > 

Tinct. cinnamomi i5'J-> 

Syrupi simplicis f ^Jvj. M. 

Dose, f5j. secunda quaque hora. 

In the diarrhoea of children. 

I£. Pulveris rhei gr. xxx. ; 

Sodii bicarbonatis gr. xv.-; 

Spiritus myristicoe TT^xxx. ; 

Syrupi zingiberis f5j-j 

Aquae menthce piperita? ad f §iss. 
Misce, fiat haustus nocte sumendus. 

Antacid and purgative. 



ROSA— ROSE. 

[Rosa Centifolia. The petals of Rosa centifolia, U. S. 
Rosa Gallica. The petals of Rosa Gallica, U. S. 
Oleum Rosse. The volatile oil obtained from the petals 
of Rosa centifolia, U. S. 

Officinal Preparations, U. S. 

Aqua Rosse (Rosa centifolia). As a vehicle. 
Confectio Rosse. As a vehicle. 

Infusum Rosse Compositum (containing sulphuric 
acid). As a vehicle. 

Mel Rosse. As a vehicle. 

Syrupus Rosse Gallicse. As a vehicle. 

Unguentum Aquse Rosse (cold cream). 



ROSEMARY — RUE. 315 

Also enters into Pilulse Aloes et Mastiches, and Syrupus 
Sarsaparill?e Compositus.] 

The various preparations of roses have little therapeu- 
tical significance. The cabbage-rose is used in the form 
of rose-water as an elegant vehicle ; the red rose petals 
as confection constitute a convenient basis for a pill mass, 
whilst, combined with sulphuric acid in the acid infusion, 
they make an excellent gargle, either alone or with alum, 
whilst they may occasionally be of service in concealing 
the nauseous flavor of sulphate of magnesia. 

Hips [dog-rose, rosce canince fructus, Br.] are also slight- 
ly astringent. 



ROSMARINUS— ROSEMARY. 

[ The leaves of Rosmarinus officinalis, U. S. 

Oleum Rosmarini. Used in perfumery. 

Is rarely used in this country except in perfume.] 
Rosemary, lavender, and peppermint are agreeable car- 
minatives, much used in combination with other stimulant 
drugs. 



[RUBUS— BLACKBERRY. 

The bark of the root of Rubus Canadensis and of Rubnsvillosus, U. S. 

Officinal Preparations, U. S. 

Extractum Rubi Fluidum. Dose, fjss. 
Syrupus Rubi. Dose, f3j.-ij. 

Much prized as a tonic and astringent, and particularly 
adapted to the diarrhoea of relaxation. A decoction is 
also made in domestic practice (3j. to Oiss., boiled down 
to a pint), of which f^j.-ij. may be given three or four 
times daily.] 



[RUTA— RUE. 

The leaves of Ruta Graveolens, U. S. 

Oleum Rutae. Dose, gtt. iij.-vj. 

Rue is stimulant, and, in large doses, is an acro-narcotic 
poison. Moderate doses have some emmenagogue effects, 
and, in cases of poisoning, miscarriage generally occurs.] 



3'6 CEVADILLA VERATRIA. 

SABADILLA— CEVADILLA. 

\_The seed of Veratrum Sabadilla {Retzius), U. S. 

Officinal Preparations. 

Veratria. Not used internally. 
Unguentum Veratriae (gr. xx. to 3j.). 

Antidotes. 

Vegetable astringent infusions, containing tannic acid, 
should be freely administered, the stomach washed out, 
followed by stimulants and an opium suppository, or ene- 
ma. Tincture of digitalis would seem to be a physiological 
antidote. Whiskey may be given hypodermically on the 
approach of collapse.] 

External Actions. 

Physiological. Therapeutical. 

The application of vera- Veratria has been used 
tria to the skin causes first with success as a local appli- 
pricking and tingling, fol- cation in cases of neuralgia 
lowed by redness and acute of the fifth nerve, but its irri- 
darting pain. To this sue- tating properties must al- 
ceeds numbness, due, in all ways be a barrier to its ex- 
probability, to some local tensive employment. [The 
anaesthetic influence on the officinal ointment generally 
extremities of the sensory requires dilution y 2 to ^. 
nerves. When used, care should be 

The slightest contact of taken not to rub the eyes 
veratria with the nasal rail- with the greasy fingers, as 
cous membrane causes vio- violent irritation may re- 
lent irritation and prolonged suit.] 
sneezing. 

Internal Actions. 

Veratria is never used internally in this country. 

Brain anal Nervous System. — No action on the brain. 

Spinal Cord. — A good deal of elaborate, but unfortu- 
nately conradictory, experimental evidence has been ad- 
duced by various observers with reference to the effects 
of veratria on voluntary movement. In the first place con- 
vulsions and even tetanic spasms may be produced by the 
administration of the drug, but these are speedily followed 



SAVINE. 317 

by paralysis and complete muscular prostration ; and the 
balance of testimony goes to show that this is due to a pri- 
mary exciting and secondary paralysing action on the mus- 
cular structures themselves. 

Heart cnid Circulation. — Veratria first increases the 
action of the heart by stimulating its motor ganglia, but 
secondary slowing and depression rapidly ensue from an 
exciting action on the vagi. 

Respiration is at first quickened, but subsequently retard- 
ed by the lowering effect of the drug on the respiratory 
centre. The temperature of the body falls. 

Digestive and Secreting Organs. — Veratria often causes 
troublesome vomiting and purging. 



SABINA— SAVINE. 

[ The tops of Juniperus Sabina, U. S. 

Dose, in substance, gr. v.-xv. 

Officinal Preparations, U. S. 

Ceratum Sabinse (fluid extract, fjiij. ; resin cerate, 
gxij.). 

Extractum Sabinse Fluidum. Dose, gtt. v.-xv. 
Oleum Sabinae. Dose, gtt. ij.-v.] 

Local Effects. 

Savin used to be applied in the form of ointment to blis- 
tered surfaces, with the view of encouraging suppuration, 
but this barbarous process is now happily abandoned. [It 
is stimulant and rubefacient, and is sometimes applied to 
warts, ulcers, and diseases of the scalp.] 

Internal Uses. 

Physiological. Th erapeutical. 

Savin is a gastro-intestinal Savin is sometimes used 
irritant, causing in large with criminal intent to pro- 
doses vomiting and purging ; cure abortion, and death has 
and it has also a powerful occasionally resulted from its 
stimulating influence on the irritant action. It is rarely 
uterus. used in medicine, although 

some authorities express faith 
in its emmenagogue powers. 
27* 



318 SUGAR SAGO. 

SACCHARUM— SUGAR. 

\_The sugar of Saccharum offccinarum, refined, U. S. 

SYRUPUS FUSCUS— MOLASSES. 

The impitre dark-colored syrup, obtained in making sugar from 
Saccharum officinarum, U. S. 

Officinal Preparations. 

Sugar enters into Pilula Ferri Carbonatis, Pilulse Ferri 
Iodidi, and the various syrups.] 

Sugar is principally used in the form of syrup as a fla- 
voring adjunct. 



[Syrupi. 

The officinal syrups are : — 

Syrupus Acacias Syrupus Pruni Virginianas 

" Acidi Citrici " Rhei 

" Allii " " Aromaticus 

" Amygdalae " Rosoe Gallicas 

" Aurantii Corticis " Rubi 

" " Florum " Sarsaparillse Comp. 

" Ferri Iodidi " Scillse 

" Fuscus " " Compositus 

" Ipecacuanhas " Senegas 

" Krameriae " Tolutanus 

" Lactucarii " Zingiberis.] 
" Limonis 



SACCHARUM LACTIS— SUGAR OF MILK. 

\_A crystalline substance obtained from whey, U. S.~\ 

Milk and sugar of milk have no special therapeutical 
properties [apart from their nourishing qualities]. 



[SAGO— SAGO. 

The prepared fecula of the pith of Sagus Rumphii, and other 
species of Sagzis, U. S. 

Used as an article of diet for the sick, thoroughly 
boiled in water (tablespoonful to the pint) and flavored 
with sugar, lemon, spice, or wine, according to taste.] 



SAGE — RED SAUNDERS. 319 

[SALVIA— SAGE. 

The leaves of Salvia officinalis, U. S. 

Officinal Preparation, U. S. 
Infusum Salvias (£ss. to Oj.). Used as a gargle. 

Sage is tonic, astringent, and aromatic. It has been 
used as a carminative in debility of the stomach with flatu- 
lence, and the infusion is a useful gargle, to which honey, 
alum, or vinegar may be added, but it strikes a black color 
with iron (tannic acid). A weak infusion is sometimes 
used as a drink in fevers to allay nausea.] 



SAMBUCUS— ELDER. 

[The flowers of Sambitcus Canadensis, U. S.~\ 

Only used in the form of the aquae sambuci [Br.], which 
is a cooling and pleasant lotion. 



SANGUINARIA— BLOODROOT. 

\_The rhizome of Sanguinaria Canadensis, U. S. 

Officinal Preparations, U. S. 

Acetum Sanguinarise (^ij. to Oj.). Dose, nrxv.-xxx. 
Tinctura Sanguinariee (^ij. to Oj.). Dose, gtt. xx.-xl.] 

This is a substance of energetic physiological properties, 
causing clonic convulsions of spinal origin, diminishing 
reflex action, weakening the force of the heart, and less- 
ening arterial tension, lowering the temperature, dilating 
the pupil, and finally causing death by respiratory para- 
lysis. It also possesses [violent] emetic properties, and 
stimulates hepatic secretion. It has been used more espe- 
cially in America, and has been found useful in atonic 
dyspepsia and duodenal jaundice, in chronic catarrh, 
and some stages of bronchitis, and may be given in doses 
of 5 to 10 minims of the tincture three times a day. [The 
root has been used as an escharotic in epithelial cancer.] 



[SANTALUM— RED SAUNDERS. 

The wood of Pterocarpus santalinus, U. S. 

Used only in pharmacy as a coloring agent, and enters 
into Spiritus Lavandulae Compositus.] 



3 2 ° 



SANTONICA. 



SANTONICA— SANTONICA. 

\_The tinexpanded flowers of Artemisia Cina. (Willfcomm Botanischt 
Zeitung, 1872, No. 9), U. S. 

Officinal Preparations, U. S. 

Santoninum. Dose, gr. ss.-iij. 
Trochisci Santonini (each, gr. ss.).] 

Local Action. 
Santonin has no local action. 



Internal Actions. 



Physiological. 

I. Brain and Nervous Sys- 
tem. — It is no doubt due to 
some influence on the brain 
that the peculiar derange- 
ment of vision [which is 
sometimes found] accom- 
panying the use of santonin, 
depends ; as no staining of 
the ocular media has been 
observed, and slight hyper- 
semi a of the retina is the 
only apparent local effect. 
Some observers note the first 
stage to be an exaggerated 
appreciation of the violet 
rays of the spectrum, but the 
most evident alteration in 
sight consists in very distinct 
yellow vision, all white ob- 
jects being seen in a more 
or less pronounced saffron 
tinge, which begins about 
half an hour after the drug 
is swallowed. Associated 
with this we find a dimin- 
ished or even abolished ap- 
preciation of the violet rays 
of the spectrum. A good 
deal of lassitude and mental 



Th erapeutical. 



I. Santonin has been re- 
commended as a remedy for 
some affections of the optic 
nerve, but no trustworthy 
evidence has yet been ad- 
duced of its efficacy. 



Santonin has not been used 
in any form of nerve disease, 
but it seems at least possible 
that it might prove of service 
in some forms of so-called 
color-blindness. 



SANTONICA. 



321 



depression usually follows 
the use of this medicine, and 
it must be cautiously pushed, 
as large doses have occasion- 
ally proved fatal from teta- 
nic spasms and coma. 

II. Respiration and Circu- 
lation. — No special influence 
on these functions has been 
noted. [In poisoning there 
is accelerated and feeble 
pulse and rapid respiration.] 

III. Secreting Organs. — 
Slight digestive disturbance 
is usually experienced, indi- 
cated by nausea, headache, 
and general malaise. 

Urinary Organs. — Re- 
markable effects are here 
noted, consisting of a bright 
yellow coloration of the 
urine, beginning five min- 
utes after a few grains have 
been swallowed, persisting 
for two or three days, and 
communicating a stain to 
linen, as in the case of jaun- 
dice. Should the urine hap- 
pen to be alkaline, the color 
assumes a blood-red tinge, 
and the same change follows 
the addition of ammonia to 
the acid secretion. At the 
same time the flow of urine 
is increased, the patient ex- 
periences an irresistible de- 
sire to micturate, and in the 
case of children this may 
even give rise to complete 
temporary incontinence. 



III. The real use of san- 
tonin in practice consists in 
its effect on the round worm, 
or as can's lumbricoides, 
which it speedily destroys. 
It appears to have no influ- 
ence over the tape-worm, 
and it is an open question 
with regard to its service in 
cases of ascaris vermicularis. 



Santonin has been recom- 
mended as a remedy for 
incontinence of urine, and is 
said to succeed occasionally 
in cases of this troublesome 
affection after other remedies 
have failed. 



Mode of Elimination. 

Santonin is supposed to combine with the soda in the 
blood, and to be given out, in part at least, by the urine. 



322 SOAP. 

Cautions. Mode of Administration. 

[Prof. Binz has related a case of santonin-poisoning in 
which, apparently, a small dose produced serious symp- 
toms. Two lozenges, containing less than a grain, were 
followed, 10 hours afterwards, by a convulsive attack which 
recurred several times during the next few days. The 
child never had convulsions before. It would seem as if 
the troches must have contained more of the drug than 
was suspected. 1 ] 

As already observed, serious symptoms have been ob- 
served to follow the use of santonin, and we shall do well 
to warn our patients of the urinary irritability which is 
invariably experienced in greater or less degree. Dr. 
Sieveking has also drawn attention to the occurrence of 
urticaria following the administration of santonin, and 
Drs. Dyce and Ogson have given a suggestive hint by 
pointing out that its long-continued use causes the devel- 
opment of cataract in young animals. 

[When retained in the system santonin becomes con- 
verted into xanthopsin, which appears in the urine. Poi- 
sonous symptoms are produced by this new substance, and 
they may be prevented by combining the santonin with a 
purgative, and in practice it is found that they are never 
produced when the santonin is combined with calomel.] 

Its taste is not unpleasant, but as it is insoluble in water 
it may be mixed with jam or treacle, or simply sprinkled 
on bread and butter. 



SAPO— SOAP. 

[ Soap made with soda and olive oil, U. S. 

Officinal Preparations, U. S. 

Ceratum Saponis. 
Emplastrum Saponis. 
Linimentum Saponis. 
Pilulse Saponis Compositae. 

Enters into Extractum Colocynthidis Compositum, 
Pilulse Aloes, Pil. Aloes et Assafcetidae, Pil. Assafcetidse, 
Pil. Opii, Pil. Rhei, Pil. Rhei Compositae, and Pil. Scillae 
Compositae.] 

1 [Phil. Med. Times, Aug. 1877, p. 551.] 



SARSAPARILLA. 323 

Soap is not applied to any therapeutical purpose, except 
the hard variety, which enters into the construction of 
some pill masses, and both the hard and soft aid in the 
construction of liniments and plasters. 

[Soft, or potassa-soap, sometimes termed green soap, 
sapo viridisy has been recommended by Hebra in alcoholic 
solution, under the name of spiritus saponatus kalinis (2 
pts. soap, 1 pt. alcohol), in the treatment of chronic eczema.] 



SARSAPARILLA— SARSAPARILLA. 

[The root of Smilax officinalis [Humboldt aizd Bonplandt}, and 
of other species of Smilax, U. S. 

Officinal Preparations, U. S. 

Decoctum Sarsaparillse Compositum (sarsaparilla, 
sassafras, guaiac, mezereon, and liquorice). Dose, f^iv. 

Extractum Sarsaparillse Fluidum. Dose, f3ss. 

Extractum Sarsaparillse Compositum Fluidum. 
Dose, f3j. 

Syrupus Sarsaparillse Compositum (giv. to Oj.). 
Dose, foss.] 

Internal Actions. 
Physiological. Therapeutical. 

Sarsaparilla has been ere- Nor is it easier to give 
dited with diaphoretic, any decided opinion regard- 
diuretic, and other powers; ing its therapeutical merits; 
but none of these have stood for whilst some surgeons, 
the test of rigid investigation, like the late Mr. Syme, 
and it is difficult to find any hold it to be quite useless, 
convenient heading under others believe it to be of 
which to class this popular service in constitutional 
drug, unless we shelve the syphilis, chronic skin disease, 
difficulty by calling it an &c. One point of difficulty 
"alterative." in arriving at any decided 

conclusion is, that it is 
usually prescribed along 
with three other drugs in 
the compound decoction ; 
but the late Mr. Gascoyne 
used to say that he had 
found great benefit in the 
treatment of the tertiary 



3?4 SASSAFRAS — SCAMMONY, 



forms of syphilis by giving 
full doses of the freshly 
made infusion. 



SASSAFRAS— SASSAFRAS. 

\_The bark of the root of Sassafras officinale, U. S. 

S ass af r as Medulla. The pith of th e stems of Sassafras 
officinale, U. S. 

Oleum Sassafras. Dose, gtt. ij.-x. 

Officinal Preparation, U. S. 

Mucilago Sassafras Medullae (3ij. to Oj.). As a col- 
lyrium. 

Enters into Extractnm Sarsaparilloe Compositum Flui- 
dum, and Decoctum Sarsaparillae Compositum.] 

This plant seems only to have acquired any therapeutic 
importance by reason of its combination with other drugs 
in the decoctum sarsaparilise comp. 



SCAMMONIUM— SCAMMONY. 

[A resinous exudation from the root of Convolvulus Scammonia, U. S. 
Dose, in substance, gr. v.-xv. 

Officinal Preparations, U. S. 

Resina Scammonii. Dose (given in milk), gr. iv.-viij. 
Extractum Colocynthidis Compositum. Dose, gr. 
v. -xxx.] 

Internal Effects. 

Physiological. Therapeutical. 
Scammony causes a good Scammony is a purgative 
deal of irritation of the ali- used in cerefiraland dropsical 
mentary canal, and produces affections; and, being corn- 
copious watery stools, often paratively tasteless, it is well 
attended with griping. For adapted for children, form- 
its proper action, previous ing a convenient purgative 
solution in the bile, and com- for the removal of ascarides. 
bination with its soda, are 
requisite. 



SQUILL. 

SCILLA— SQUILL. 

[The bulb of Scilla maritima, U. S. 

Dose, in substance, gr. ij. 



3 2 5 



Officinal Preparations, U. S. 

Acetum Scillse (^ij. to Oj.). Dose, nrx.-xx. 

Syrupus Scillse. Dose, f^ss. 

Pilulse Scillae Compositse (squill gr. ss., ammoniac 
and ginger each gr. j.). Dose, 3 to 5 pills. 

Syrupus Scillse Compositus (tartar emetic gr. i 
f5j.). Dose, gtt. x.-f5j. 

Tinctura Scillse (*ij. to Oj.). Dose, tr^x.-xx. 

Extractum Scillse Fluidum. Dose, nuj.-iij.] 



in 



Internal Effects. 



Physiological. 

In large doses, squill may- 
act as an emetic, and cause 
violent vomiting with purg- 
ing. 

It also stimulates the bron- 
chial mucous membrane, 
and increases the urinary- 
secretion. 



Therapeutical. 

Squill is never used as an 
emetic [except for children 
in the form of i 'Hive Syrup,' ' 
Syrupus Scillae Compositus, 
which has been recommend- 
ed in spasmodic croup. To be 
repeated at short intervals, 
until vomiting occurs]. 

It is, however, a good ex- 
pectorant, increasing the 
bronchial secretions, and is 
one of the most universal 
additions to prescriptions for 
the relief of various chronic 
lung affections, as bronchitis, 
and also in whooping-cough. 

It is also a tolerably effi- 
cient diuretic, only to be 
used, however, when no irri- 
tation exists about the kid- 
neys. 



28 



326 



BROOM. 



SCOPARIUS— BROOM. 

\_The tops of Sarothamnus Scoparius ( Wi??wier), U. S.~\ 

Local Effects. 
No local action has been described. 

Constitutional Actions. 



Scoparius is an excellent 
diuretic, and is largely used 
for the purpose of removing 
dropsical accumulations. If 
we can succeed in stimulat- 
ing the kidneys effectually 
by a combination of this and 
other drugs, we may hope to 
hold in check and disperse 
the anasarca of cardiac and 
chronic kidney-disease, and 
to aid the removal of the 
watery fluid of hydrothorax 
and ascites. 



Scoparius has some influ- 
ence over the digestive and 
secreting organs, causing, in 
large doses, vomiting and 
purging, but in smaller in- 
creasing very considerably 
the urinary water. Two act- 
ive principles have been ex- 
tracted from the drug, re- 
garding whose physiological 
actions some difference of 
opinion exists. Thus scopa- 
rin is believed by one class 
of observers to be the diu- 
retic factor in broom-tops, 
whilst others assert that it 
has no such property. Spar- 
tein has also been very va- 
riously described, but the 
balance of testimony goes 
to show that it has very de- 
finite toxic powers, lowering 
the reflex action of the spinal 
cord, paralysing the motor 
nerves, suspending the elec- 
trical excitability of the va- 
gus, and finally causing death 
by respiratory paralysis. 

Dose and Mode of Administration. 
Scoparius is seldom prescribed alone, but is most usually 
made the basis of diuretic mixtures, on the well-known 
principle of combination, which is here of essential service. 
fy. Potassii acetatis 5J SS - > 

Aceti scillse * 5' v - 5 

Decocti scoparii [Br.] ad f^vj. M. 

Fiat mistura. Capiat unciam unam quartis horis. 



$. 



SENEKA. 




Tincturoe digitalis 


l^x.; 


Spiritus aetheris nitrosi, 




Spiritus juniperi 

Succi scoparii [Br.] 

Aquae 

Ter die sumend. 


aa f 5 SS - 5 

f5j.;. 

ad f^j. 



3 2 7 



M. 



SENEGA— SENEKA. 

[ The root of Polygala Senega, U. S. 
Dose, in substance, gr. xx. 

Officinal Preparations, U. S. 

Decoctum Senegae (3j. to Oj.). Dose, f^j. 
Extractum Senegse (alcoholic). Dose, gr. j.-iij. 
Extractum Senegae Fluidum. Dose, tttx.-xxx. 
Syrupus Senegae. Dose, f 3j. 
Syrupus Scillae Compositus.] 

Local Effects. 
No external or local action has been described. 

Constitutional Actions. 
Physiological. Therapeutical. 

The principal action of Senega is of great service 
senega is that of stimulating in the more chronic condi- 
the mucous membrane of the tions of pneumonia and 
bronchial tubes, and possi- bronchitis, where it seems 
bly, by a tonic influence on to help the patient to get 
their muscular tissues, facili- rid of the large quantities of 
tating the expulsion of their secretion frequently accu- 
contents. It has also been mulated within the lungs, 
accredited with diaphoretic, Theoretically at least, its 
diuretic, and emmenagogue stimulating properties would 
properties, but is seldom contra-indicate its use in the 
employed in any other more acute pulmonary affec- 
capacity than as an expec- tions, but in the later stages 
torant. of bronchitis, and more 

especially those cases occur- 
ring among the very old 
and young, it is of real 
value. 

Dose and Mode of Administration. 
The infusion is the preparation most commonly em- 



3 2 $ SENNA. 

ployed, and it is generally combined with carbonate of 
ammonia and other expectorants. Thus : 

R. Ammonii carbonatis gr. iv. ; 

Tincturse scillse TT^xv. ; 

Tinct. camphorse comp. [Br.] T»|xxv. ; 

Extracti glycyrrhizge gr. v. ; 

Infusi senegas [Br.] ad f §j. M. 

Fiat haustus ter die sumendus. 



SENNA— SENNA. 

[The leaflets of Cassia acutifolia (D elite), of Cassia abovata (Be Can- 
dolle), and of Cassia elongata (Lemaire, Journ. de P/iarm.. vii., 
345), U. S. 

Officinal Preparations, U. S. 

Confectio Sennse. Dose, 3j.-ij. 
Extractum Sennse Fluidum. Dose, f 5j.-iv. 
Infusum Sennse (gj. to Oj.). Dose, fgij.-iv. 
Tinctura Rhei et Sennse. Dose, fgss.-ij. 
And enters into Syrupus Sarsaparillae Comp.] 

Internal Effects. 
Physiological. Therapeutical. 

Senna irritates the small Senna is a most useful 
intestine, causing copious, purgative, ranking among 
thin, yellow evacuations, and the cathartics with slightly 
stimulating the peristaltic drastic tendencies, and it 
movements of the bowel. may be prescribed in simple 

constipation, in dyspepsia, and 
in a large variety of condi- 
tions where rapid and effec- 
tual unloading of the bowels 
is required. 

Dose and Mode of Administration. 

Senna is seldom prescribed alone, as it is then apt to 
cause irregular contraction of the intestines and griping. 
It is therefore usually combined either with other purga- 
tives, as mag. sulph. [black draught], or with various 
aromatics, as in the confection and compound mixture. 

Cassia and tamarinds have both a slightly purgative 
action, but are only used as ingredients in various com- 
pound preparations, as the confection of senna. 



SNAKEROOT — MUSTARD. 329 

SERPENTARIA— VIRGINIA SNAKEROOT. 

[ The root of Aristolochia Serpentaria , of Aristolochia reticulata, and 
of other species of Aristolochia, U. S. 

Officinal Preparations, U. S. 

Extractum Serpentarise Fluidum. Dose, gtt. xx. 
Infusum Serpentariae (Jss. to Oj.). Dose, f,5j.-iv. 
Tinctura Serpentarise (§ij. to Oj.). Dose, f3j--ij-] 

This drug is probably a gentle tonic, but the other 
virtues with which it has been credited seem to rest on no 
very stable foundation. [It belongs to the class of the 
aromatic bitters, and is a good addition to other tonics, as 
in the popular Huxham's tincture — Tinctura Cinchonoe 
Comp.] 



[SEVUM— SUET. 

The prepared suet of Ovis Aries, U. S. 

Used only in pharmacy, and as an ingredient in Cera- 
tum Resinse Compositum, Unguentum Hydrargyri, and 
Ung. Picis Liquidse.] 



SINAPIS— MUSTARD. 

[Sinapis Alba. The seed of Sinapis alba, U. S. 
Sinapis Nigra. The seed of Sinapis nigra, U. S. 

Officinal Preparation, U. S. 
Charta Sinapis. Mustard papers, 4 inches square.] 

Local Actions. 
Physiological. Th ei'apeutical. 

Mustard applied to the Mustard is used, firstly, for 
skin causes a vivid redness, the relief of pain, and there 
with violent smarting and can be no doubt of the bene- 
itching, and, if the applica- fit thus derived in manyner- 
tion be continued too long, vous, rheumatic, and in- 
vesication may follow, and flammatory affections. In 
even troublesome ulcera- neuralgia, lumbago, sciatica, 
tion. pleurodynia, pleurisy, pneu- 

monia, peritonitis, colic, and 
a vast variety of painful 
28* 



330 MUSTARD. 

disorders, we may expect to 
alleviate suffering in some 
measure by the use of sina- 
pisms, and at other times we 
use this mode of drawing 
blood to the surface, and so 
relieving the congestion of 
deeper parts, on the principle 
referred to under the head- 
ing of "Counter-irritation." 

Mustard poultices are most 
valuable in arousing patients 
from the dangerous coma- 
tose condition into which 
they occasionally drift in 
the course of some of the 
acute inflammations; and 
sinapisms applied to the feet 
and calves are of service in 
the stupor of narcotic poison- 
ing and in urcemic coma. 

Mustard baths may be 
employed to bring back the 
eruption of some abortive 
cases of the exanthemata, 
or as a stimulant in acute 
bronchitis or in the convul- 
sions of children. 

Constitutional Actions. 
Physiological. Therapeutical. 

Digestive Organs. — Mus- Mustard is extensively 
tard increases the appetite used as a dietetic condiment, 
by irritating the mucous 
membrane of the stomach, 
but does not increase the 
secretion of gastric juice. 

It acts as a prompt and This emetic power is of 
effectual emetic of the direct great value in cases of poison- 
class, ing, as mustard is always at 

hand, and can be used at 
once. 



SODIUM. 33I 

Mode of Administration. 

A mustard poultice must be made with cold water, for 
we know that hot water dissipates the volatile oil on which 
the counter-irritation depends, vinegar destroys it, and 
alcohol prevents its formation. It must be kept on from 
twenty minutes to half an hour, according to circumstances. 



SODIUM— SODIUM. 

[Sodii Acetas. Acetate of Sodium. Dose, gr. xx.-3ij. 

Sodii Bicarbonas Venalis. (In making Aqua Acidi 
Carbonici, and Sodii Bicarbonas.) 

Sodii Boras (Borax). Dose, gr. x.-xl. 
Mel Sodii Boratis (3j. to fgj.). 
Glyceritum Sodii Boratis (J5ij. to f^j.)- 

Sodii Carbonas. (In making Aluminii Sulphas, Anti- 
monii Oxysulphuretum, Bismuthi Subnitras, Cadmii Sul- 
phas, Bismuthi Subcarbonas, Calcii Carbonas Prsecipitata, 
Ferri Subcarbonas, Liquor Sodse, Liquor Sodas Chlorinatae, 
Pilula Ferri Carbonatis, Pilulse Ferri Composite, Potassii 
et Sodii Tartras, Sodii Carbonas Exsiccata, Sodii Phosphis, 
and Zinci Carbonas Praecipitata.) 

Sodii Chloridum (table-salt). (In making Calomel 
and Corrosive Sublimate.) 

Sodii Hypophosphis. Dose, gr. x.-xxx. 

Sodii Hyposulphis. Dose, gr. x.-xx. 

Sodii Nitras. (In making Sodii Arsenias.) 

Sodii Sulphas (Glauber's Salt). Dose, .fss.-j. (In 
making Sodii Carbonas.) 

Sodii Sulphis. Dose, 3j- 

Officinal Preparations, U. S. 

Soda. Caustic Soda. 

Liquor Sodse. Dose, well diluted, n^v.-x. 
Sodii Arsenias. Dose, gr. y^—J. 

Liquor Sodii Arseniatis. Dose, nyij.-v. 

Sodii Bicarbonas. Dose, gr. x.-xx. 
Pulveres Effervescentes. Soda powders. 
Pulveres Effervescentes Aperientes. Seidlitz powders. 
Trochisci Sodii Bicarbonatis. 



S3 2 SODIUM. 

Sodii Carbonas Exsiccata. (Used in making Sodii 
Arsenias.) 

Sodii Phosphas. Dose, as a cholagogue, gr. xx.-xl. ; 
as a purgative, oj--ij- (Used in making Ferri Phosphas 
and Ferri Pyrophosphas.) 

Liquor Sodae Chlorinatae (Labarraque's Solution). 
Dose, f 3ss.— ij. , well diluted.] 

Effects and Uses. 

The soda salts have none of the depressing action on the 
heart which we have seen to be possessed by potash. 

Locally, we may use soda in acute eczema; or the hypo- 
sulphite in parasitic skin-disease, where it acts in virtue of 
the contained sulphurous acid; and the biborate, or borax. 
as a gargle, as a lotion in pruritus and various skin diseases, 
and as an application to ulcerations about the mouth. 

Soda is not so much used internally as a remedy for 
gout and rheumatism, because the urate of soda is less solu- 
ble than the urate of potash ; but it is one of our best reme- 
dies in those forms of dyspepsia with pain after food, weight 
at the stomach, red fissured tongue, cough, and palpita- 
tion. The hyposulphite is useful in sarcinous vomiting. 

Chloride of sodium is a good emetic ; the phosphate 
and tartrate are purgative, and none of the preparations 
appear to be decidedly diuretic in their action. 

Seidlitz Powder. [Pulvis Effervescens Aperiens,U. S.] 

R. Sodae tart. [Br.] [Potassii et Sodii tart.] gij. ; 

Sodae bicarbonatis gr. xl. 

Misce, ut fiat haustus effervescens cum Acidi tartarici 
gr. xxxv. et aquae f §iv. Statim sumendus. 

IJ. Sodii bicarbonatis gr. xx. ; 

Tinct. calumbae rr^xx; 

Syrupi zingiberis f.^ss. ; 

Infusi gentianae compositi ad f ^j. 
Misce, ter die sumend. 

Useful draught in dyspepsia. 

[The following is a pleasant antacid combination, 
known as — 



MARSH-ROSEMARY. 333 

Scda-Mint. 

R. Sodii bicarbonatis, 

Sacchari aa 5'j '■> 

Spiritus ammonii aromatic! H|xl. ; 

Aquae menthse piperitse q. s. ad f §viij. M. 

S. Dose, a tablespoonful after meals. 

Used in flatulent dyspepsia. It admits the addition of 
tr. nux vomica or syrup of rhubarb.] 



[SPIGELIA— PINKROOT. 

The root of Spigelia Marylandica, U. S. 

Dose, in substance, 3j- 

Officinal Preparations, U. S. 

Extractum Spigelise Fluidum. Dose, fjj.-ij. 
Extractum Spigeliae et Sennse Fluidum. Dose, 

f3ij.-iv. 

Infusum Spigeliae (£ss. to Oj.). Dose, f^iv.-viij. ; 
for a child, f 5ij--f 3J« 

Spigelia is an efficient remedy against the round worms, 
or lumbricoids, and, in moderate doses, is entirely safe ; but 
in overdoses has narcotic properties. It is given in infu- 
sion or syrup, morning and evening, for two or three days, 
followed by a brisk cathartic] 



[SPIRITUS FRUMENTI— WHISKEY. 

Spirit obtained from fer7nented grain by distillation, and containing 
from 48 to 56 per cent, by volume, of absolute alcohol, U. S. 



SPIRITUS MYRCIiE— BAY-RUM. 

The spirit obtained by distilling ru?n with the leaves of Myrcia acris, 

{Schwartz), U. S. 



SPIRITUS VINI GALLIC!— BRANDY. 

The spirit obtained from fermented grapes by distillation, and contain- 
ing from 48 to 56 per cent, by volume, of absolute alcohol, U. S. 

For effects and uses, see Alcohol.] 



[STATICE— MARSH-ROSEMARY. 

The root of Statice Limonium, variety Caroliniana, U. S. 

Statice is a powerful, indigenous astringent, and may be 



334 STRAMONIUM. 

used as a substitute for kino and catechu. It has been 
quite popular as an application to ulceration of the throat. 
In scarlatina, it is used both as an internal and local 
remedy. The infusion or decoction is generally employed.] 



[STILLINGIA— STILLINGIA (QUEEN'S-ROOT). 

The root of Stillingia sylvatica, U. S. 
Dose, in substance, gr. xx. 

Officinal Preparation, U.- S. 
Extractum Stillingiae Fluidum. Dose, nrxx.-xl. 

Stillingia is highly esteemed as an alterative in secondary 
syphilis, skin-diseases, and scrofula. In large doses it is 
emetic and cathartic. As an alterative, it is frequently 
given in combination with sarsaparilla. A decoction (^j. 
to Oiij. boiled to Oj.), dose, f^j.-ij.; and a tincture (,$ij. 
to Oj.), dose f5j-> are largely used in the South, but are 
not officinal.] 



STRAMONIUM— STRAMONIUM. 

[Stramonii Folium. The leaves of Datura stramo- 
nium, U. S. 

Stramonii Semen. The seed of Datura stramonium, 
U. S. 

Officinal Preparations, U. S. 

Extractum Stramonii Foliorum. Dose, gr. ^~^- 
Extractum Stramonii Seminis. Dose, gr, %- T /2- 
Tinctura Stramonii (seeds ^ij. to Oj.). Dose, nrx.-xx. 
Unguentum Stramonii (extract 3j- to ^j.). 

Antidotes. 

Same as for belladonna-poisoning.] * 

After the careful description already given of the actions 
and uses of belladonna, it is unnecessary to say much about 
stramonium. Modern investigation has shown that the 
active principle, datura, is identical with atropia ; and the 
only marked difference between the two plants seems to 
consist in the more decided antispasmodic properties of 



STORAX — SULPHUR. 335 

stramonium, which cause it to be much prized as a remedy 
for asthma. In the purely spasmodic varieties of that 
disease, and most efficiently when inhaled in the form of 
smoke, it seldom fails to give relief. 



[STYRAX— STORAX. 

A balsam prepared from the bark of Liquidambar orientate {Lamarck), 

U. S. 

Storax has been recommended as a substitute for copaiba 
in the treatment of gonorrhoea and gleet; and mixed with 
olive oil, equal parts, is effectual in the treatment of scabies. 
It is ranked as a stimulating expectorant, but is chiefly used 
as an ingredient in the compound tincture of benzoin.] 



SULPHUR— SULPHUR. 

[Sulphur Lotum. Sublimed sulphur, thoroughly washed 
with water, U. S. 

Sulphur Sublimatum. Sublimed sulphur, U. S. 

Officinal Preparations, U. S. 

Sulphur Praecipitatum. Dose, 5j--iij- 
Sulphuris Iodidum. Not used internally. 
Unguentum Sulphuris (i part sulphur, 2 parts lard). 
Unguentum Sulphuris Iodidi (gr. xxx. to ^j.). 

Sublimed sulphur is used in making Emplastrum Ammo- 
niaci cum Hydrargyro, Hydrargyri Sulphuretum Rubrum, 
Potassii Sulphuretum, Sulphur Praecipitatum, and Sulphuris 
Iodidum.] 

External Use. 

Sulphur is used externally as a stimulant in various 
forms of chronic skin-disease, such as acne faciei, and 
more especially in itch, a disease dependent on the pre- 
sence of a minute insect, the acarus scabiei, the male of 
which ranges freely over the skin, whilst the female re- 
tires with her eggs to oblique burrows in the cuticle. 
These receptacles having been broken up by soap and 
water, sulphur ointment is carefully spread over all the 
patient's body at bed-time, and washed away by a warm 
bath next morning. Two or three applications of this sort 



33 6 



SULPHUR 



are sufficient to cure the disease, and if the patient's skin 
will bear the unguentum sulphuris, one smearing with this 
may be sufficient. The rationale of the treatment is, not that 
sulphur acts as a direct poison to the acarus, but that it 
forms with lard a very tenacious and adhesive substance 
which suffocates the insect by blocking up its air-pores. 
[The sulphur ointment should generally be diluted j^J to 
y^, as it is apt to produce too great irritation.] 

Sulphur is also in great favor as a popular remedy for 
rheumatism, sprinkled on new flannel and applied to the 
painful part, and there is no doubt that some beneficial 
action may thus be caused. Lastly, sulphur makes a use- 
ful bath in some forms of chronic skin disease. 

Internal Use. 



Physiological Action. 

i. It has been supposed 
to exert a stimulating influ- 
ence on the mucous mem- 
branes and skin. 



2. It causes slight increase 
of the peristaltic movements 
of the bowels. 



Therapeutical Action. 

i. In virtue of this, it 
used to be occasionally pre- 
scribed in chronic bronchitis 
and phthisis, and also used 
externally in skin-diseases. 
To its action on the skin 
may be attributed its un- 
doubted power of aiding, 
— more especially in the 
form of bath, — the elimina- 
tion of lead and mercury 
from the system. Sulphur 
has lately been recom- 
mended as the best means 
of preventing mercurial sali- 
vation. 

2. It acts, therefore, as a 
gentle laxative, slightly 
softening the faeces, and 
from the mildness of its 
action it is specially useful 
in piles and all irritable 
conditions about the rectum. 
Its purgative action is in- 
creased by its being dissolved 
and formed into a sulphide 
by the alkali of the bile. 



SULPHUROUS ACID. 337 

3. Sulphur has well- 3. Burnt in a room with 

marked antiseptic properties closed doors and windows, 

in consequence of its de- it is the best way to remove 

structive power over the the germs of infection from 

lower forms of vegetable the air by fumigation, 
life. 

Sulphur is given off from the system principally by the 
bowels, ^.but also by the milk, the sweat, and the skin, 
in the form of sulphuretted hydrogen, and by the urine 
as a sulphate. 

Strong applications of sulphur frequently irritate the 
skin, and bring on troublesome eczema. The disadvan- 
tage of sulphur as an aperient is the offensive odor which 
the sulphuretted hydrogen communicates to the faeces. 

The confection [Br.] is the best purgative form [con- 
taining sulphur ifiv., and cream of tartar ^j., in syrup of 
orange-peel f^iv.], in tea- or tablespoonful doses, and for 
external use the ointment is generally prescribed. 



ACIDUM SULPHUROSUM— SULPHUROUS ACID. 

[An aqueous solution of 'sulphurous acid gas, having the odor of burn- 
ing sulphur, and a sulphurous, sour, a?zd somewhat astringent taste. 
Its specific gravity is about 1.035.] 

Dose, f3ss. ad fjj. [Largely diluted with water.] 
External Use. 

The therapeutic properties of this acid depend in part 
on its very poisonous influence on the lowest forms of ani- 
mal and vegetable life. Thus it forms a good application 
to those varieties of skin disease, as tinea tonsurans, chlo- 
asma, &c, which depend on the presence of a minute 
cryptogamic plant ; and Dr. Dewar some years ago pub- 
lished a pamphlet in which he ascribed to this acid powers 
little short of marvellous. Going on the theory that a very 
great number of diseased conditions depend on the irrita- 
tion of germs, Dr. Dewar most confidently advised its use 
in affections ranging from rheumatic fever to chilblains. 
Although experience has naturally not borne out his ex- 
travagant assertions, we have to thank him for making 
known to us the undoubtedly good effect of sulphurous 
acid in various forms of sore throat, used in considerable 
dilution either as spray or gargle. It is also a good dis- 
29 



338 SULPHURIC ACID. 

infectant, as we know that the antiseptic properties of sul- 
phur, when burnt for purifying purposes, depend on its 
formation. 

Internal Use. 

Sulphurous acid has been recommended by Dr. Lawson 
in pyrosis, the dyspeptic symptoms attending which are 
due to various forms of leptothrix and' vegetable growths 
burrowing in the mucous membrane of the stomach ; and 
in flatulence it is also deserving of a trial. 



ACIDUM SULPHURICUM— SULPHURIC ACID. 

\_Salphuric acid of the specific gravity 1.843, ^ S. 

Officinal Preparations, U. S. 

Acidum Sulphuricum Aromaticum. Dose, n^v.-xx. 
Acidum Sulphuricum Dilutum (foij. to Oj.) Dose, 
n^v.-xx. 

Also enters into the manufacture of Acidum Sulphuro- 
sum, Aluminii Sulphas, Atropiae Sulphas, Cadrnii Sulphas, 
Ferri Sulphas, Hydrargyri Sulphas Flava, Liquor Ferri 
Subsulphatis, Liquor Ferri Tersulphatis, Oleum ^Ethereum, 
Quinise Sulphas, Acidum Hydrocyanicum Dilutum, ^Ether, 
Argenti Cyanidum, Chloroformum Purificatum, Hydrar- 
gyri Chloridum Corrosivum, Hydrargyri Chloridum Mite, 
Hydrargyri Cyanidum, Pyroxylon, Sodii Phosphas, Spiri- 
tus iEtheris Nitrosi, and Veratria. 

Antidotes. 

Alkalies, which should be given in milk or soapsuds, 
though much water would be improper. Care should be 
taken not to rupture the stomach by the tube of the stomach- 
pump or by inducing severe efforts at vomiting. The acid, 
when concentrated, discolors the mouth and lips, making 
a black slough. When administered medicinally it should 
be taken much diluted through a glass tube, in order to 
protect the teeth.] 

External Use. 

Strong sulphuric acid is the most powerful caustic of this 
group, rapidly charring and desiccating the tissues, from 
its great affinity for water. M. Velpeau, of Paris, strongly 
recommended its use in cancer, the acid being made into 



SULPHURIC ACID — JUICES. 339 

a paste with saffron, and applied to the morbid growth, it 
being found, after detachment of the sloughs, that a clean 
ulcerating surface remained ; and Professor Syme pro- 
posed a modification of this plan, on the score of economy, 
by using sawdust instead of saffron. Ricord, of Paris, also 
advises the application of sulphuric acid in combination 
with charcoal to [primary] syphilitic ulcers, holding that, 
if this process is effectually carried out before the fourth 
day, we may hope to avert the evil consequences of con- 
stitutional infection. 

Mr. Pollock has advised the local use of strong sulphuric 
acid in caries and necrosis and suppurating synovial mem- 
brane of joints, either applied on a glass rod, or injected, 
or brought in contact on lint with the diseased surfaces, in 
the proportion of one part of acid to two, three, or six 
parts of water ; and this plan of treatment has been used 
with good success in St. George's Hospital {vide "Lancet," 
May 28, 1870, and "Medical Times and Gazette," De- 
cember 11, 1875). 

Internal Use. 

Diluted sulphuric acid is a good astringent, and as such 
is extensively used [in night sweats and] in diarrhoea, more 
especially that which is so common in summer. It has 
also been advised, in the form of lemonade, as a prophy- 
lactic against painters'' colic, and there is no doubt that it 
heightens materially the action of purgative salts, probably 
by increasing their solubility. 

Ijt,. Magnesii sulphatis §ij. ; 

Ferri sulphatis gr. xxiv. ; 

Acidi sulphurici diluti f t ~ij ; 

Infusum calumbae ad ffviij. 

Misce, fiat mistura. Capiat cochlearia duo magna 
omni mane. 

R. Acidi sulphurici diluti f5'j ss - > 

Tincturse opii f 5l- ; 

Syrupi aurantii f§j. ; 

Aquse ad ffviij. M. 

S. Capiat unciam unam ter in die post singulas sedes 
liquidas. 



[Succi. 

The class of officinal Juices, U. S. P., consists of Succus 
Conii and Succus Taraxaci.] 



34° TOBACCO. 

TABACUM— TOBACCO. 

[The commercial dried leaves of Nicotiana Tabaciim, U. S. 

Officinal Preparations, U. S. 

Infusum Tabaci (3j. to Oj.). Dose, f3ij.-iv. 
Oleum Tabaci. Not used internally. 
Unguentum Tabaci. (Watery extract of leaves ,^j. to 
Sjxvj. of lard.) 
Vinum Tabaci. Dose, gtt. xx. 

Antidotes. 

Strychnia and diffusible stimulants may be regarded as 
physiological antidotes to tobacco ; and, after thoroughly 
washing out the stomach, tincture of digitalis may be ex- 
hibited to counteract the depressing influence of the poison 
on the heart, and the tendency to collapse. Respiration 
should be stimulated by ammonia, frictions, and even 
maintained artificially. Sulphate of strychnia may be given 
hypodermically, and stimulating enemata injected.] 

Effects and Uses. 

Tobacco is now rarely, if ever, used in medicine, on 
account of its poisonous properties ; but it is a substance 
in such general domestic use, and therefore of so great 
physiological interest, that we must devote some little 
space to considering the results of modern experiment on 
its action. 

Local Action. 

Physiological. Therapeutical. 

Tobacco is readily ab- Tobacco has been used as 

sorbed by the skin, and a local application in prurigo 

symptoms of poisoning have and other skin diseases, but 
followed the application of is too readily absorbed to 

strong infusions to the un- deserve recommendation for 



'to 



broken cuticle. this purpose. 

Internal Action. 

i . Brain and Nervous Sys- i . Before the introduction 

tem. — The brain seems to be of chloroform, advantage 

little affected, but some ex- was taken of the depressing 

citement of the spine is an and relaxing influence of 



TOBACCO. 



341 



early symptom of the poi- 
sonous action of the drug, 
speedily followed, however, 
by muscular relaxation and 
paralysis, also of spinal ori- 
gin. 

The sensory nerves are 
not affected, but we find 
lowering of the functional 
activity of the motor nerves. 
The pupil is contracted. 



2. Circulation and Respi- 
ration. — It is not necessary 
for us to go into the elaborate 
and contradictory series of 
experiments made to prove 
the fact that tobacco is a 
powerful depressant of the 
heart's action. The temper- 
ature usually falls in tobacco- 
poisoning, and death ensues 
from respiratory paralysis. 
[Excessive use of tobacco 
produces functional disor- 
der of the heart, which may 
result in hypertrophy, dila- 
tation, and organic disease.] 

29 



tobacco on the muscular sys- 
tem to employ the enema in 
strangulated hernia and dis- 
locations. Any occasional 
success, however, was amply 
counterbalanced by the in- 
conveniences and even dan- 
gers which too often result- 
ed; and this application of 
the drug has now fallen into 
well-merited oblivion. 

In consequence of its low- 
ering action on the reflex 
function of the spinal cord, 
it has been proposed as a 
remedy for tetanus and an 
antidote for strychnia, and 
the alkaloid nicotia will be 
found most convenient for 
these purposes. 

The use of tobacco is be- 
lieved to have some injurious 
effect on vision ; and Hutch- 
inson and others have re- 
corded instances of atrophy 
of the optic nerve and total 
blindness thus produced. 

2. Tobacco-smoking has 
been known to give relief 
in asthma and chronic bron- 
chitis. 



342 TAMARIND — DANDELION 

3. Digestive and Secreting 
Organs. — Tobacco usually 
causes nausea and vomiting, 
as most smokers can testify ; 
but toleration is soon estab- 
lished, and even considera- 
ble doses then fail to disturb 
the equanimity of the diges- 
tive organs, save a slightly 
purgative action on the bow- 
els. It is stated, however, 
that in habitual smokers 
some symptoms of dyspepsia 
may be detected, indicated 
by furred tongue and loss of 
appetite ; and there is also 
some generally-diffused, gra- 
nular irritation about the 
pharynx. 



[TAMARINDUS— TAMARIND. 

The preserved fruit of Tamarindus Jndica, U. S. 

Tamarinds are laxative, and are used in making a re- 
frigerant drink for the sick. They enter into the Confectio 
Sennse.] 



[TAPIOCA— TAPIOCA. 

The fe cut a of the root of Janipha Manihot (Bot. Mag. 3071), U. S. 

Tapioca, the starch of the Cassava plant, is used like 
arrowroot as an article of diet.] 



TARAXACUM— DANDELION. 

[ The root, gathered in the autiwin, of Taraxacum Dens-leonis 
(De Candolle), U. S. 

Officinal Preparations, U. S. 

Extractum Taraxaci. Dose, gr. xx.-xxx. 
Extractum Taraxaci Fluidum. Dose, f5j--ij- 
Infusum Taraxaci (gij. to Oj.). Dose, f^iv. 
Succus Taraxaci. Dose, f3ij.— iv.] 

Taraxacum is usually prescribed as a matter of routine 



TURPENTINE. 343 

in sluggish liver and the various forms of dyspepsia depend- 
ing on a supposed deficiency of bile ; but although it may 
have some mild tonic, [diuretic, and aperient] properties, 
there is not the slightest evidence for asserting that it ex- 
erts any real influence over the hepatic functions. 

U. Succi taraxaci f5J-> 

Acidi nitro-muritici dil. U1_x. ; 

Tincturse lupulinse TT^xx. ; 

Aquae ad f§j. M. 
S. Ter die sumend. 



TEREBINTHINA— TURPENTINE. 

[The concrete oleo-resin obtained from Pinus pahisiris, and from 
other species of Pinus, U. S. 

TEREBINTHINA CANADENSIS— CANADA 
TURPENTINE. 

The liquid oleo-resin obtained from Abies balsamea (Lindley, Flor. 

Med.), U. S. 

Enters into Ceratum Resinse Compositum, Emplastrum 
Galbani Compositum (of Turpentine), and Charta Can- 
tharidis and Collodium Flexile (of Canada Turpentine). 

OLEUM TEREBINTHINA— OIL OF 
TURPENTINE. 

The volatile oil distilled from the turpentine of Pinus palustris 
and of other species of Pinus, U. S. 

Dose of oil of turpentine rtvx.-xx., given 3 or 4 times 
daily, in typhoid fever or chronic dysentery, or f3j. to 
f^ss. as a vermifuge. 

Officinal Preparation, U. S. 

Linimentum Terebinthinae. 

And enters into Linimentum Cantharidis.] 

Local Action. 

Physiological. Therapeutical. 

Turpentine, when applied This effect of turpentine 

to the skin, causes redness, causes it to be much used as 

tingling, and irritation, lead- a counter-irritant in those 

ing on to acute inflammation cases where we wish to re- 
and blistering, if not removed lieve congestion of internal 

within a limited period. organs by driving the blood 



344 



TURPENTINE 



to the surface. Thus, in 
peritonitis, pneumonia, bron- 
chitis, and asth7?ia, it is fre- 
quently employed, either 
sprinkled on hot flannel, or 
in the form of thelinimentum 
terebinthinae of the Pharma- 
copoeia. 



Constitutional Actions. 



Physiological. 

i. On the Brain. — Tur- 
pentine produces, in large 
doses, giddiness, and other 
symptoms somewhat resem- 
bling alcoholic intoxication, 
and even ending in coma in 
rare instances. 

2. Circulation. — Turpen- 
tine acts at first as a stimulant 
to the heart, and has undoubt- 
ed astringent properties, 
partly, no doubt, from its 
coagulating influence on the 
albumen of the tissues, but 
also by causing contraction 
of the smaller vessels. 



3 . Digestive and Secreting 
Organs. — Turpentine is dis- 
tinctly irritating to the ali- 
mentary canal, frequently 
causing vomiting and diar- 
rhoea, and it has the property 
of checking mucous secre- 
tions from the various ca- 
nals. 

It is also a very certain 
diuretic of the stimulating 
class, but must be used with 



Therapeutical. 



2. As an astringent, tur- 
pentine is valuable in various 
forms of haemorrhage, but 
more especially in that from 
the kidney and in purpura 
hemorrhagica [but is now 
rarely used as a haemostatic, 
oil of erigeron Canadense, 
ergot, and the mineral as- 
tringents, being more reli- 
able, and less irritating]. 

3. Turpentine is a valua- 
ble astringent in some forms 
of diarrhoea, and more espe- 
cially that which results from 
the later and ulcerative stage 
of enteric \_typhoid~\ fever. 
It is highly recommended 
in the same disease by some 
authorities when abdominal 
pain and distension coincide 
with a raw, clean, dry tongue, 
and in ordinary tympanites 



TURPENTINE. 



345 



caution, as it is apt to cause 
frequent and painful mictu- 
rition with bloody urine, and 
eventual suppression of the 
secretion, [strangury,] and 
acute inflammation of the 
kidneys. 



it makes a good addition to a 
purgative enema. It has been 
recommended by Dr. King 
Chambers as an enema in 
sciatica, where it is supposed 
to act locally on the affected 
nerve, which, at one part of 
its course, lies directly in 
contact with the large intes- 
tine, and it has long enjoyed 
a well-deserved reputation 
as an anthelmintic in cases 
of tape-worm. 

Turpentine has also been 
given in small doses to check 
the excessive secretion in 
some forms of bronchitis, 
and it may also be of service 
in chronic cystitis, gleet, and 
pyelitis. 

It has also been used in 
iritis with alleged success, 
though it is difficult to see 
on what principle. 

Mode of Elimination. 

Turpentine is rapidly absorbed into the blood, and as 
quickly passes out, principally by the lungs and kidneys, 
imparting to the urine a peculiar violet odor. 

[Old oil of turpentine is considered an efficient antidote 
against phosphorus-poisoning.] 

Dose and Mode of Administration. 

Be. Olei terebinthinae f^j. ; 

Mucilaginis f ^v. ; 

Mistura amygdalae, 

Aquae laurocerasi [Br.] aa f^ss. M. 
S. f 3j • P r o dosi quartis horis. 

A few drops may be given on a lump of sugar, in hae- 
morrhage. 

As an anthelmintic, half an ounce may be prescribed 
[combined with an ounce of castor oil, and is very effective 
against round worms as well as tamice]. 



;46 



OYSTER- SHELL — TINCTURES. 



[TESTA— OYSTER-SHELL. 

The shell of Ostrea ediilis, U. S. 

Officinal Preparation, U. S. 

Testa Prseparata. Dose, gr. x.-xl. 

Calcined oyster-shell, consisting of 98 percent, of carbo- 
nate of calcium, is used in impalpable powder as an antacid 
in dyspepsia. Castillon's powders consisted of sago, salep, 
tragacanth, each in powder, aa 3j«» prepared oyster- 
shell 3j., and some cochineal as a coloring ingredient. A 
decoction of this powder in milk (5j. to Oij.) may be used 
freely as an article of diet in bowel-affections. ~\ 



[Tinctura. 

The officinal Tinctures are: — 

Tinctura Aconiti Radicis Tinctura 

" Aloes 

«« " et Myrrhae 

" Arnicse 

" Assafcetidae 

' ' Aurantii 

" Belladonnae 

" Benzoini 
" " Composita 

'* Calumbae 

'.' Cannabis 

" Cantharidis 

" Capsici 

" Cardamomi 
" " Composita 

" Castorei 

" Catechu 

" Cinch on ae 
" " Composita 

" Cinnamomi 

" Colchici 

" Conii 

" Cubebse 

" Digitalis 

" Ferri Chloridi 

" Gallae 

" Gentianae Composita 

" Guaiaci 
" " Ammoniata 



Hellebori 
Humuli 

Hyoscyami 
Iodinii 

" Composita 
Jalapae 
Kino 
Krameriae 
Lobeliae 
Lupulinae 
Myrrhae 
Nucis Vomicae 
Opii 

" Acetata 

" Camphorata 

" Deodorata 
Quassiae 
Rhei 

" et Sennae 
Sanguinariae 
Scillae 
Serpentariae 
Stramonii 
Tolutana 
Valerianae 

" Ammoniata 
Veratri Viridis 
Zingiberis.J 



TRAGACANTH BEARBERRY. 347 

TRAGACANTHA— TRAGACANTH. 

\A gummy exudation from Astragalus vertis ( Olivier}, and fr w om other 
species of Astragalus, U. S. 

Officinal Preparations, U. S. 
Mucilago Tragacanthse, as a vehicle. 

Trochisci Acidi Tannici, Trochisci Ipecacuanhas, Tro- 
chisci Potassii Chloratis, Trochisci Santonini, and Trochisci 
Zingiberis.] 

Tragacanth is of service as a vehicle for the suspension 
and division of various powdered drugs. 



[Trochisci. 

The officinal Lozenges are: — 

Trochisci Acidi Tannici Trochisci Menthae Piperitas 

" Cretas " Morph. et Ipecacuanhas 

" Cubebse " Potassii Chloratis 

" Ferri Subcarbonatis " Santonini 

" Glycyrrhizae et Opii " Sodii Bicarbonatis 

" Ipecacuanhas " Zingiberis.] 

" Magnesias 



ULMUS— SLIPPERY-ELM. 

\_The inner bark of Ulmus fulva {Michaux), U. S. 

Officinal Preparation, U. S. 

Mucilago Ulmi.] 

Elm bark is probably tonic and astringent, but is rarely 
if ever used [except as an emollient application in external 
inflammations, such as erysipelas]. 



[UVA PASSA— RAISINS. 

The dried fruit of Vitis Vinifera, U. S. 

Raisins are laxative, and are used as a flavoring to 
demulcent beverages. They enter into the tincture of 
rhubarb and senna.] 



UVA URSI— BEARBERRY. 

[ The leaves of Arctostaphylos Uva Ursi (Sprengel, Syst., II. 287), U. S. 

Officinal Preparations, U. S. 

Decoctum Uvse Ursi (Jj. to Oj.). Dose, f,liv. 
Extractum Uvse Ursi Fluidum. Dose, f5j.] 



348 



VALERIAN. 



Uva ursi is astringent and 
possibly diuretic. [It is also 
tonic and antilithic, and is 
believed to favor uterine 
contraction.] 



The astringency of this 
drug being principally di- 
rected to the genito-urinary 
mucous membrane, it is held 
by surgeons to be of some 
service in various chronic 
affections of these parts. 



VALERIANA— VALERIAN. 

[ The root of Valeriana officinalis, U. S. 

Officinal Preparations, U. S. 

Extractum Valerianae. Dose, gr. x.-xxx. 
Extractum Valerianae Fluidum. Dose, f3j. 
Infusum Valerianae (f^ss. to Oj.). Dose, f Jij.-iv. 
Oleum Valerianae. Dose, gtt. iv.-v. 
Tinctura Valerianae (£ij. to Oj.). Dose, f 3 j . — Ij . 
Tinctura Valerianae Ammoniata (gij. to Oj.). Dose, 
f 5j--ij-] 

Effects and Uses. 



Various elaborate investi- 
gations have been made in 
Germany on the physiologi- 
cal actions of valerian, but 
they have not much bearing 
on its practical application, 
and the drug itself is hardly 
of sufficient importance to 
justify us in devoting much 
time to its consideration. 
We may therefore say, 
generally, that acceleration 
of the action of the heart, 
mental hallucinations, gid- 
diness, and some digestive 
derangement are among the 
principal of the symptoms 
described most fully by 
Phillips. 



The more important 
therapeutic applications of 
valerian have not stood the 
test of time and experience, 
and its use is now practi- 
cally restricted to hysteria 
and the various nervous 
conditions depending there- 
on. [In nervous headache, 
the ammoniated tincture is 
a reliable resource in doses 
of f5ij. 

The oil is the active prin- 
ciple.] 



WHITE HELLEBORE. 349 

[ACIDUM VALERIANICUM— VALERIANIC ACID. 

A colorless liquid, of an oily consistence, a penetrating disagreeable 
odor, and caustic taste. Its specific gravity is 0.935. ^* •$. 

Officinal Preparations, U. S. 

Ammonii Valerianas. Dose, gr. ij.-v. 
Quiniae Valerianas. Dose, gr. j.-iij. 
Zinci Valerianas. Dose, gr. j.-ij. 

Properties. 

Valerianic acid is an example of an organic acid made 
by synthesis, through the oxidation of amylic alcohol 
(fusel oil) by chromic acid. The valerianate of the oxide 
of amyl makes an artificial fruit-essence, when largely 
diluted. 

Valerianic acid resembles valerian in its effects, and, in 
the form of the valerianates, may be used in nervous head- 
ache, neuralgia, and hysteria. The salts are best given 
dissolved in simple elixir or in pill.] 



[VANILLA— VANILLA . 

The prepared unripe fruit of Vanilla aromatica, U. S. 

Used as a flavoring ingredient in Trochisci Ferri Sub- 
carbonatis, and Trochisci Potassii Chloratis.] 



VERATRUM ALBUM— WHITE HELLEBORE. 

[ The rhizome of Veratrum album, U. S.J 

White hellebore possesses some of the physiological pro- 
perties of veratrum viride, but much of its energy is ex- 
pended on the alimentary canal, and violent vomiting and 
purging often follow its use. It is, therefore, now quite 
discarded from medical practice. When applied to the 
nostrils, it causes intense sneezing. 

Two alkaloids [in addition to veratria] have been dis- 
covered in the root-stalk, one of which has been called 
jervia, and the other veratralbia. 

[For Veratria see Sabadilla.] 

3° 



35o 



AMERICAN HELLEBORE. 



VERATRUM VIRIDE— AMERICAN HELLEBORE. 

[ The rhizome of Veratrum viride, U. S. 

Officinal Preparations, U. S. 

Extractum VeratriViridisFluidum. Dose, gtt. j.-iij. 

Tinctura Veratri Viridis (oviij. to Oj.). Dose, 
gtt. iij.-vj. 

(Dr. Norwood's tincture is of the same strength as the 
officinal tincture.)] 

Some local action has been observed, of an irritant na- 
ture, somewhat resembling that of veratria. . 



Constitutional Actions. 



Physiological. 

1. Brain and Nervous Sys- 
tem. — i. Green hellebore 
has no action on the brain. 

2. Spinal Cord. — A very 
decidedly depressing effect 
is exerted on the spine, in- 
dicated by extreme muscu- 
lar prostration. 

II. Heart a?id Circulation. 
Veratrum viride is also a 
powerful vascular depres- 
sant, the pulse rate being 
lowered, and the arterial 
tension diminished ; these 
effects being due both to a 
direct action of the drug on 
the heart muscle and to 
stimulation of the cardiac in- 
hibitory nerves. 



III. No effect is produced 
on the respiration, but a dis- 
tinct lowering of tempera- 
ture has been observed. 



Th erapeutical. 



II. Veratrum viride has 
been extensively used in 
America on account of its 
depressing influence on the 
circulation, and it is stated 
that we may get good results 
by prescribing it in the early 
stages of pneumonia and 
other inflammatory condi- 
tions. Little or no English 
experience, however, has 
yet been brought to bear on 
the discussion of this ques- 
tion. 



WINES — ZINC. 35 E 

IV. Digestive and Secret- [IV. The nauseating and 

ing Organs. — Veratrum vi- depressing effects are best 

ride has emetic properties, counteracted by opium and 

and frequently causes vomit- alcoholic stimulants.] 
ing; and purging, also, not 
unfrequently follows its use. 

Two alkaloids exist in veratrum viride, jervia and vera- 
troida, the main difference between which seems to be, 
that the latter is apparently responsible for the digestive 
disturbance which occasionally results. 





[Vina. 




The officicinal Wines 


are : — 




Vinum Aloes 




Vinum Opii 


" Antimonii 




" Portense 


" Colchici Radicis 




" Rhei 


" " Seminis 




" Tabaci 


" Ergotse 




" Xericum.] 


" Ipecacuanhae 







ZINCUM— ZINC. 

[Officinal Preparations, U. S. 

Zinci Oxidum. Dose, gr. ij.-viij. 
Zinci Oxidum Venale. 

Unguentum Zinci Oxidi (i to 5). 
Zinci Chloridum. As a caustic and astringent. 

Liquor Zinci Chloridi. (Burnett's Disinfecting Fluid.) 
Zinci Acetas. As a collyrium, gr. ss.-ij. to f^j. 
Zinci Carbonas Prsecipitata. 

Ceratum Zinci Carbonatis (1 to 5). 
Zinci Sulphas (white vitriol). Dose, as an emetic, 
gr. x.-xxx. 

Zinci Valerianas (given in pill). Dose, gr. i.-ij. 

Antidotes. 

The alkalies and alkaline carbonates are the chemical 
antidotes to the salts of zinc. Evacuation of the stomach 
and bowels should be followed by the exhibition of eggs 
and milk. The retching, colicky pains, and diarrhoea, 
may be relieved by morphia hypodermically.] 



35 2 



ZINC. 



Local Actions. 



Physiological. 

Chloride of Zinc is an 
exceedingly powerful cans- 
tic, and, in weak solution, 
has astringent properties. 
The sulphate and oxide are 
also astringent in varying 
proportions. 



Th erapeutical. 

Chloride of Zinc has 
been used as a caustic for 
the treatment of cancerous 
and other ulcerations, either 
in strong solution, sub- 
stance, or arrow - shaped 
masses made with flour, and 
inserted into incisions 
around the base of the mor- 
bid mass. It has turned out 
to be the principal ingre- 
dient in all so-called cancer 
curers' nostrums, and is em- 
ployed in legitimate surgery 
as an application to wounds 
from which cancerous 
growths have been removed, 
and also (in the strength of 
gr. lx. ad fjj.) to the raw 
surface after ordinary opera- 
tions, with the view of pre- 
venting pyaemia. 

Sulphate of Zinc is a 
much-valued astringent lo- 
tion in conjunctivitis, and 
makes an excellent injection 
in gonorrhoea and leucor- 
rhoea; and the oxide, either 
in powder or ointment, is 
one of the most useful 
applications in chronic skin- 
disease. 

Internal Actions and Uses. 



Physiological. 
i . Action on Nervous Sys- 
tem. — This is probably tonic 
in character, and some 
astringent properties may 
also be noted. 



Therapeutical. 
i. We can thus explain 
the benefit which sometimes 
results from the use of sul- 
phate of zinc in chorea. We 
here .begin with a grain, and 
continue in gradually in- 



GINGER. 353 

creasing doses up to 6 or 
8 grains, tolerance being 
rapidly established, and the 
emetic action of the drug 
avoided. Oxide of zinc, in 
doses from i to 5 grains, is 
an excellent remedy in the 
night-sweats of phthisis, and 
it is also a valuable aid to 
treatment in the diarrhxa of 
children. 
2. On Digestive System. — 2. It is therefore our most 
Sulphate of zinc promptly reliable direct emetic, in- 
and effectually empties the valuable in cases of poison- 
stomach, without causing ing, in doses of from 20 
much depression or nausea, to 30 grains. 

R. Zinci sulphatis gr. xxx. ; 

Aquae f^iij- M. 

Fiat haustus emeticus statim sumendus. 



R. Zinci chloridi 


g r - j- ; 


Aquae rosae 


f§iv. M. 


A good injection in gonorrhoea. 




R. Zinci oxidi 


5y«; 


Glycerini 

Liquor plumbi subacetatis 
Aquae calcis 
Fiat lotio. 


f5ij.; 

f5iss. ; 
ad f §vj. M. 


Useful in impetigo. 




R. Zinci valerianatis 


gr. xxiv. ; 


Confectionis rosae 


q. s. 


Fiat massa in pilulas duodecim 


dividenda. Deaurentur 


pilulae. 




Nervine tonic. 





ZINGIBER— GINGER. 

\The rhizome of Zingiber officinale (Roscoe, Trans. Linn. Soc), U. S. 
Dose, in substance, gr. x.-xv. 

Officinal Preparations, U. S. 

Extractum Zingiberis Fluidum. Dose, n^x.-xx. 
Infusum Zingiberis (Jss. to Oj.). Dose, f^ij.-iv. 
Oleo-resina Zingiberis. Dose, n^ss.-ij. 

3°* 



354 GINGER. 

Syrupus Zingiberis. As a vehicle. 
Tinctura Zingiberis (%iv. to Oj.). Dose, f3ss.-j. 
Trochisci Zingiberis (each containing nyj. of the 
tincture.). 

Also enters into Acidu'm Sulphuricum Aromaticum, 
Pilulae Scillge Compositae, Pulvis Aromaticus, Pulvis Rhei 
Compositus, and Vinum Aloes.] 

Ginger is an agreeable stimulant and carminative. 



Having now completed the study of the various articles 
contained in the national Pharmacopoeia, we shall proceed 
to give a brief resume of the properties of the most useful 
among those drugs which have not yet received full official 
sanction. Among these will be found some very import- 
ant remedies, in addition to plants of great physiological 
interest, whose active medicinal powers have not yet been 
fully tested in practical medicine, and whose investigation 
opens up a valuable field for clinical observation. 



REMEDIES IN FREQUENT USE, BUT NOT 

INCLUDED IN THE PRIMARY LIST OF 

THE MATERIA MEDICA, U. S. P. 



[AZEDARACH— AZEDARACH. 

The bark of the root of Melia Azedarach, U. S. Secondary. 

The bead-tree, or Pride of China, is largely used in the 
Southern States as an anthelmintic, resembling spigelia in 
its effects. The decoction (^ij. to Oij. boiled to Oj.) is 
generally employed; the dose to a child being a table- 
spoonful frequently repeated, until it purges.] 



BRAYERA— KOOSSO. 

[The flowers and unripe fruit of Br ay era antheimintica, U. S. 

Secondary. ] 

Effects. 

Physiological. Th erapeutical. 

The action of kousso is It is therefore occasionally 
poisonous to the tape-worm, used as an anthelmintic, and 
without exerting any irritat- with moderately good effect 
ing or purgative effect. when given on an empty sto- 

mach, according to the rules 
generally laid down. 

Mode of Administration, &c. 

It is well not to use the officinal tincture [Br.], but to 
get the fresh flowers, boiling about half an ounce in 3 or 
4 oz. of water, adding a little lemon peel, and directing 
the patient to swallow the whole draught, dregs and all. 
A little vomiting sometimes follows, but is seldom trouble- 
some. [A brisk cathartic should follow in 3 or 4 hours.] 



356 EUCALYPTUS GLOBULUS. 

ARECA— [BETEL NUT, Ph. B.]. 

This nut possesses some astringent properties, and has 
been used with success as an anthelmintic. 



BEL^E FRUCTUS— INDIAN BAEL [Ph. B.]. 

Indian bael, containing tannin, has astringent proper- 
ties, and has been highly praised as an effectual cure for 
the more chronic forms of dysentery. Only partial con- 
firmation is given by home experience to the evidence 
furnished from abroad ; but this may be explained not only 
by the limited opportunities of testing its efficacy in this 
country, but because the drug is probably much more 
active when used in a perfectly fresh state. 



CURCUMA— TURMERIC. 

\_The rhizome of Curcuma longa, U. S. Secondary. ] 

Turmeric is not used in medicine. It forms the coloring 
ingredient in curries, and the theory has recently been 
broached that the yellowish tint so often observed on the 
skin of Anglo-Indians results from the absorption of the 
pigment of this substance. 

EUCALYPTUS GLOBULUS [Ph. B.]. 

Eucalyptus is an excellent antiseptic, proving rapidly 
destructive to infusoria. 

It paralyses the spinal cord and medulla, a period of 
preliminary excitement rapidly giving way to profound 
muscular weakness, loss of reflex activity, and finally death 
from respiratory failure. 

The pulse loses in force, the temperature is lowered, 
and the excretion of urea is increased. 

As regards the therapeutics of the drug, it appears to 
have been used with success as an antiperiodic ; and there 
seems to be no doubt that the presence of the plant in large 
numbers deprives malarious districts of much of their 
virulence. 

It has also been recommended in bronchitis and asthma. 

Dose of the tincture, f 3ss. to f 3ij. [The fluid extract 
may also be used, but the oil is the best preparation. 
Dose, gtt. v.-x.] 



JABORANDI. 



357 



FEL BOVINUM PURIFICATUM- 
OX-BILE [Ph. B.]. 



-PURIFIED 



Bile is well known to act 
as a laxative, to aid the di- 
gestion of the fatty and amy- 
laceous constituents of our 
diet, and to prevent the de- 
composition of food within 
the intestines, with conse- 
quent flatus and digestive 
disturbance. 



It has therefore been sup- 
posed that when a deficiency 
of bile is suspected, we may 
hope to derive advantage 
from ox-gall administered in 
gelatine capsules, so that its 
action may be deferred until 
it reaches the small intes- 
tines. In some forms of dys- 
pepsia and in chronic diar- 
rhoea it is said to be a useful 
remedy, but little clinical 
evidence on this point can 
be adduced. 



GOA POWDER— [ARAROBA]. 

Has been extensively used in the East, recommended 
by Sir Joseph Fayrer in cases of ringworm and psoriasis. 
We may dissolve a scruple in an ounce of hot lard to 
make an ointment. 

Prof. Attwood having discovered that chrysophanic acid 
is the principal ingredient of Goa powder, Mr. Balmanno 
Squire has proved the efficacy of this substance in the 
same class of cases, making an ointment also with hot lard 
in the proportion of 3U- t0 %)• 



JABORANDI. 

Constitutional Action. 



Physiological. 
Within ten or twelve min- 
utes after jaborandi has been 
taken, the face flushes deep- 
ly, and profuse perspiration 
follows, accompanied by a 
great increase of salivary 
secretion. The loss of fluid 
thus produced is very con- 
siderable, and the sweat has 
been proved to contain a 



Therapeutical. 

The powerful diaphoretic 
action of jaborandi, no less 
than its power in aiding the 
elimination of urea, would 
seem to suggest its use in 
various chronic kidney-dis- 
eases [Bright's disease], as 
well as febrile conditions. 
But its action is too short, 
sharp, and sudden, and too 



358 



JABORANDI, 



much depression and incon- 
venience are produced, to 
render us very hopeful of its 
ultimate success in practice. 
It has been prescribed in 
diabetes insipidus, and for 
the purpose of augmenting 
the secretion of milk. 



large excess of urea. This 
action on the skin is consi- 
dered due to vaso- motor 
paralysis and consequent 
dilatation of the cutaneous 
arterioles, and the sialagogue 
effects of the drug are attri- 
buted to stimulation of the 
periphery of the nerves sup- 
plied to the salivary glands. 
Jaborandi increases some- 
what the action of the heart; 
and contraction of the pupil, 
with impaired accommoda- 
tive power, has been noted 
to attend its use. 

A good deal of nausea, 
depression, and general dis- 
comfort result, and have 
been graphically described 
by Mr. Martindale in the 
" Lancet." 

Atropia appears to be in 
many respects an exact phy- 
siological antidote to jabo- 
randi. 

[The alkaloid of Jaborandi possessing both the diapho- 
retic and sialagogue actions of the drug, has received the 
name of — 

Pilocarpia — Pilocarpin. 

Constitutional Effects. 



Physiological Effects. 

Dr. Popow (St. Petersb. 
Med. Woch., Aug. 4), re- 
porting upon the results de- 
rived from the hypodermic 
injection of pilocarpin in 
men in health and suffering 
from fever, and in experi- 
ments upon animals made in 
Prof. Suschtschinsky's labo- 



Therapentic Uses. 
From some comparative 
trials which he has made 
with the internal adminis- 
tration of pilocarpin, Dr. 
Curschmann believes that 
the in frequency with which 
it causes vomiting, as com- 
pared with jaborandi, is prin- 
cipally due to its being used 



JABORANDI. 



359 



ratory, comes to the follow- 
ing conclusions : — 

i. Pilocarpin produces 
the same effect as an infusion 
of the leaves of jaborandi. 

2. An injection of from 
o.oi to 0.02 gramme (gr. y§ 
to yz) induces abundant 
sweating, without causing 
the unpleasant effects (gid- 
diness, vomiting, cephalal- 
gia) produced by jaborandi, 
and is, therefore, better 
suited for therapeutical em- 
ployment. 

3. The temperature di- 
minishes without any prior 
exaltation, from one hour 
and a half to four hours, and 
reaches its minimum soon 
after the cessation of the 
sweating. 

4. The increased excretion 
of saliva is observed alike in 
the healthy and the sick, 
after doses of from 0.01 
to 0.015 gramme (gr. ]/& to 
%). Sweating only occurs 
in such doses in the healthy; 
fever patients, e. g., typhus, 
requiring 0.02 gramme 

(gr. Vs). 

5. The quickening of the 
heart's action produced by 
the pilocarpin continues a 
pretty long time after small 
doses, but when large ones 
are employed, this is soon 
replaced by retardation. 

6. On the direct introduc- 
tion of pilocarpin into the 
veins a retardation of the 
heart's action takes place 



hypodermically, and there- 
by avoiding direct irritation 
of the stomach. Some per- 
sons, especially those who 
have been weakened by prior 
disease, complain of a sense 
of debility, but this usually 
soon passes off; but in others 
a complete state of collapse 
is produced, which may or 
may not be connected with 
prior vomiting. The possi- 
bility of this occurrence must 
always be borne in mind. 
It is dependent upon the 
amount of the dose and the 
susceptibility of the indi- 
vidual. It is oftenest met 
with in women, and in those 
whose strength has been 
greatly reduced ; and when 
the patient's constitution is 
not known, the first dose of 
the medicine should not ex- 
ceed 0.02 (gr. yi), while its 
effect should be watched for 
a quarter or half an hour. 
As far as the trials have gone, 
pilocarpin does not seem to 
act dangerously on the sub- 
jects of heart-disease, and, 
indeed, can be employed 
when no other diaphoretic 
procedure, for so long a pe- 
riod, would be ventured 
upon. Indeed, as a thera- 
peutical agent for the pro- 
duction of diaphoresis, it is 
superior to any other method 
in use, being more easily em- 
ployed, while its action is 
more certain and more com- 
plete, without being more, 



360 



JABORANDI. 



suddenly, without any prior 
acceleration. 

7. Doses not exceeding 
0.03 gramme (gr. j4) do 
not exert any particular ef- 
fect on the alimentary canal ; 
but large doses, 0.05 to 0.10 
gramme (gr. f to gr. jss.) 
induce purging, or even 
bloody stools, with intestinal 
movements, and the devel- 
opment of gases. 1 



or even as dangerous, as 
most of these. Its superior- 
ity over the various sweat- 
ing-baths in ascites, hydro- 
thorax, asthma, etc., is most 
marked. It is true that dia- 
phoretic treatment is thought 
less of than formerly ; but 
in several cases the difficulty 
of its application, rather than 
its inefficacy, is the cause 
of its not being resorted to. 
Speaking from his own ex- 
perience, Dr. Curschmann 
has found the pilocarpin 
very useful in oedema, in 
dropsy of the cavities from 
heart or lung disease, and in 
chronic nephritis, etc., and 
that after diuretic, drastic, 
and other means have failed. 
He believes that a large field 
for its employment may be 
found in pleurisy, accompa- 
nied by serous exudation, 
both in promoting the ab- 
sorption of this, and in pre- 
venting its re-accumulation 
after paracentesis. It is 
evidently indicated in chro- 
nic rheumatic affections, at 
least so far as these are ame- 
nable to diaphoretic treat- 
ment. 2 



Mode of Action on Salivary Glands. 

Mr. J. N. Langley (Journal of Anatomy and Physio- 
logy, Oct. 1876) gives the following as the results of ex- 

1 [Medical News and Library, Fhila., Oct. 1877, p. 154; from the 
Med. Times and Gaz., Aug. 25, 1877.] 

2 [Phila. Med. and Surg. Reporter for Oct. 6, 1877.] 



JABORANDI. - 361 

periments made by him to determine the action of pilo- 
carpin on the submaxillary gland of a dog : — 

"In small doses, i. e. up to 30 mgr. (gr. ^), pilocar- 
pi exerts an action on the gland very similar to that pro- 
duced by stimulation of the chorda tympani. 

"It causes a rapid secretion and a considerable increase 
of blood-flow ; both secretion and blood-flow gradually 
declining. 

"Its effects are little if at all altered by sections of the 
chorda tympani or of the sympathetic nerve. Stimulation 
of the chorda tympani increases the pilocarpin effects, i. e. 
the nerve is functionally unaltered. Stimulation of the sym- 
pathetic diminishes its effects, so that this nerve, too, is 
functionally unaltered. The secretion is stopped by in- 
jecting atropia (a fact for some time known), but a quan- 
tity of atropia sufficient to paralyze the chorda tympani does 
not prevent a relatively large quantity of pilocarpin from 
producing its ordinary results. In fact, the secretion or 
absence of secretion is dependent on the relative quantity 
of the two poisons present, just as in the stand-still or beat 
of the heart. 

"In larger doses, instead of causing a stronger saliva- 
flow, it causes none at all, and further prevents the chorda 
tympani from producing any secretion. It considerably 
diminishes the blood-flow through the gland, as well as 
the effects of the chorda tympani on the blood-flow. 

"It does not, however, stop the sympathetic secretion. 
The action indeed is not very dissimilar to that of atropia; 
this agrees with its action on the vagus and inhibitory 
apparatus of the heart, where in large doses it prevents any 
inhibition of the heart from stimulation of the vagus, or of 
the junction of sinus venosus, just as atropia does." 1 

Mode of Administration, and Dose. 

The infusion of the powdered leaves is a good method 
of exhibiting the drug. A drachm should be steeped 
in half a pint of hot water, and when sufficiently cool 
stirred up and one-half the quantity drunk, half an 
hour later the remainder should be taken, without strain- 
ing the infusion. This is generally sufficient to cause 
profuse sweating within an hour. Ptyalism is less con- 

1 [Am. Journ. Med. Sci., Jan. 1877.] 

3 1 



362 SOLUTION OF DIALYSED IRON. 

stant in its occurrence. Drs. Tyson and Bruen 1 have de- 
termined that the amount of urine and the excretion of 
urea are both increased during the twenty-four hours 
succeeding the administrations. 

The ordinary dose of pilocarpin is gr. y 2 . Gerrard also 
found that the nitrate and hydrochlorate of pilocarpin in 
doses of one-half a grain, also produced the full effects of 
jaborandi in substance. 

The fluid extract of jaborandi is now largely used, the 
dose being a fluid-drachm, representing a drachm of the 
leaves. An elixir is also made by some pharmacists con- 
taining the virtues of one drachm in six fluid-drachms. 
Dose f3j.-f ^ss.] 



[LIQUOR FERRI DIALYSATUS — SOLUTION OF 
DIALYSED IRON. ' 

(Not officinal.) 

This preparation, of recent introduction, is rapidly 
coming into favor. It is a clear, neutral, very deep wine- 
colored liquid, free from taste and apparent astringency, 
and bearing perfectly dilution with pure water. 2 It is a 
pure and powerful chalybeate with all the advantages of 
iron in the usual form ; it is borne well by the stomach, 
and does not cause constipation nor distress the diges- 
tion. Chemically it would appear to be a ferric hydrate 
kept in solution by a small quantity of ferric chloride. It 
is made by precipitating ferric chloride with dilute water 
of ammonia, washing the ferric hydrate precipitated, dis- 
solving it in a solution of ferric chloride, and placing the 
result in a dialyser. Graham, the inventor of the process, 
believed that muriatic acid passes through the dialyser, 
mainly, and that the iron is left in the form of the soluble, 
colloidal, ferric hydrate; but in practice it has never been 
obtained entirely free from the chloride. Dialysed iron 
would seem to furnish us with an efficient substitute for the 
hydrated sesquioxide in the treatment of poisoning by arse- 
nious acid. It is precipitated by various salts, and should 
be administered alone in doses of from ten drops to half 
a drachm, after meals. It claims to contain about the same 

1 [Am. Journ. Med. Sci., July 1, 1877.] 

2 [Phila. Med. Times, vol. vii. p. 492, article on Dialysed Iron.] 



KAMALA — PEPSIN. $6$ 

proportion of iron as the muriated tincture, and, as it is 
said not to injure the teeth, it proves an admirable substi- 
tute for it, in chlorosis, anozmia, and allied conditions.] 



ROTTLERA— KAMALA, U. S. Secondary. 

[ The glandular powder and hairs obtained from the capsules of Rottlera 
tinctoria (Roxburgh), U. S. 

Dose, 5j -iij.] 

Effects. 

Physiological. Therapeutical. 

Kamala is a vermicide, Kamala is an efficient an- 

killing the tape-worm rapid • thelmintic, differing from 

ly ; it also possesses purga- other remedies of the class 

tive properties. in its cathartic action. 



LARICIS CORTEX— LARCH BARK [Ph. B.]. 

Larch bark is seldom if ever used in medicine. 



LAUROCERASI FOLIA— CHERRY-LAUREL 
LEAVES [Ph. B.]. 

This drug contains prussic acid, but, as it is very variable 
in strength, its use cannot be advised. 



MORI SUCCUS— MULBERRY JUICE [Ph. B.]. 
Is only used as a flavoring ingredient. 

[PEPSINA PORCI]— PEPSIN. 

Pepsin is the most import- There can be little doubt 
ant digestive element of the that many dyspeptic condi- 
gastric juice, and more espe- tions are due to a deficiency 
cially reduces the albumi- of gastric juice, and attempts 
noid and proteinaceous con- may be made to supply this 
stituents of food to a fit state by prescribing pepsin, pre- 
for absorption. ferably in combination with 

dilute hydrochloric acid. 

In atonic dyspepsia, in va- 
rious ancemic and cachectic 
conditions, in the diarrhoea 
of children, in some forms of 



3^4 PARSLEY — SALICIN. 

spasmodic asthma, its use 
seems to be attended with 
good results; but we may 
well share Dr. Wood's scep- 
ticism as to the possibility of 
materially aiding the diges- 
tion of food by the small 
doses usually prescribed. 

Pepsin has also been re- 
commended as an addition 
to nutritious enemata, so as 
to insure some preliminary 
digestion of the injected 
food. 

Dose, 2 to 5 grains. Or we may use Prof. Liebreich's 
Pepsin-Essenz. [It may be conveniently prescribed in the 
form of Saccharated Pepsin, Liquor Pepsini, Boudault's 
Acid Pepsin, or as Lacto-peptine.] 

[PETROSELINUM— PARSLEY. 

The root of Petroselinum sativum (Lindtey, Flor. Med.), 
U. S. Secondary. 

The neutral, active principle, Apiol, has attained some 
reputation in the treatment of intermittents, and is also 
used in neuralgia and dysmenorrhea. Its nauseating taste 
requires it to be given in capsule (gr. 3 T 9 ^). Dose, one 
to four.] 

RHAMNI SUCCUS— BUCKTHORN [Ph. B.]. 

Buckthorn has some purgative properties, but is never 
used in modern practice. 



SALICIN. 

Salicin acts as a bitter tonic, and has some antiseptic and 
antiperiodic qualities, which have caused it to be used, 
with only partial success, in the treatment of 7nalarial 
affections. Recently, however, it has been most exten- 
sively employed, on the recommendation of Dr. Maclagan, 
as a remedy for acute rheumatism, in which disease from 
io to 30 grains, every two, three, or four hours, in powder 
mixed with water, generally succeeds, within forty-eight 
hours, in relieving pain and reducing temperature. 



SALICYLIC ACID. 



365 



ACIDUM SALICYLICUM— [SALICYLIC ACID]. 

Local Action. 



Physiological. 

Salicylic acid is an excel- 
lent antiseptic, delaying pu- 
trefaction and preventing 
decomposition. 



Being 



Therapeutical. 

less irritant than 
carbolic acid, it has been 
proposed as a substitute for 
that substance in carrying 
out Lister's antiseptic sys- 
tem. It has also been rec- 
ommended as a good lotion 
to raw surfaces ; but Callen- 
der has shown that it not only 
tends to irritate the wounds, 
but frequently brings out a 
crop of irritable vesicles in 
their neighborhood. 



Constitutional Action. 



Salicylic acid is an anti- 
septic and antipyretic, rap- 
idly reducing temperature 
in feverish conditions, al- 
though, in a state of health, 
the drug seems to be without 
influence on the body heat. 
Some headache, giddiness, 
and ringing in the ears have 
been observed, but the car- 
diac and respiratory func- 
tions are not sensibly affect- 
ed. 

Elimination principally 
takes place by the urine. 



Salicylic acid is now uni- 
versally allowed to be a most 
efficient remedy in acute 
rheumatism, very rapidly 
reducing temperature, re- 
lieving pain, and, in fact, 
cutting short the disease. By 
shortening the duration of 
the joint inflammation, it 
naturally limits the tendency 
to cardiac complication ; 
but it seems to have no influ- 
ence over developed peri- 
carditis, or in averting or ar- 
resting conditions of hyper- 
pyrexia. 



Dose, Mode of Administration, &c. 

We may give salicylic acid in 20-grain doses, repeated 
hourly for six hours on two consecutive days, and continued 
at shorter intervals, if the disease resists forty-eight hours' 
medication. 

The disadvantages attending its use are an unpleasant 
burning sensation in the throat, with the occasional devel- 

3 T * 



366 SALICYLIC ACID. 

opment of catarrhal symptoms; gastro-intestinal irritation, 
resulting probably from an impure preparation containing 
carbolic acid ; and a peculiarly irritable erythematous and 
vesicular inflammation of the skin. A still more formida- 
ble objection, however, to its long-continued use, is the 
property it seems to possess of softening the long bones, 
and injuriously affecting the teeth by abstracting their salts 
of lime. 

Salicylic acid is very insoluble, and it is difficult to find 
a ready medium for its administration. Messrs. Savory 
and Moore have devised a very elegant granular, efferves- 
cent preparation, or we may use the salicylate of soda in 
10-grain doses. The following are good formulae: — 

JJ. Acidi salicylici 3J-j 

Olei amygdalae [expressi] i 5 V - ; 

Pulv. acaciae 5i)ss. ; 

Syrupi amygdalae 1 5 v j- ; 

Aquae aurantii flores ad f <jhj. M. 
S. Capiat f gj. pro dosi. 

For children. 

R. Acidi salicylici 5J« > 

Sp. rect. i 3>j ss « > 

Dissolve. 

Potassii citratis f5J-> 

Syrupi aurantii f 5513. ; 

Aquae f^djss. 

Mix the two solutions and filter, and then dilute with 
water to taste. 

[Note. — Prof. Germain S6e has just read at the Academy of Medi- 
cine, an elaborate memoir (which is published in detail in the Union 
Medicale of July 3 et seq.~) entitled "Studies on Salicylic Acid and the 
Salicylates ; and on the Treatment of Acute and Chronic Rheumatism, 
Gout, and various Affections of the Sensory Nervous System, by the 
Salicylates," in which he speaks of this new article of the materia med- 
ica in most enthusiastic terms. He treats at full length of the history, 
chemistry, physiological and therapeutical action of this substance; but 
we have only space for transcribing his conclusions as to its therapeu- 
tical effects. 

"1. As an external antizymotic agent, salicylic acid has an incon- 
testable action, but in no wise superior to that of carbolic acid, its only 
advantage being its privation of odor. As an internal antiseptic, it 
manifests no appreciable effect in either purulent affections or contagious 
and parasitical diseases — as diphtheria, or muguet, or gangrene, or 
finally in diabetes. 

"2. As an antipyretic, salicylic acid and the salicylates possess only 
transitory and doubtful properties, even when specific, miasmatic, viru- 



SUMBUL. 367 

lent fevers, etc., are in question. Even the salicylate of quinia occu- 
pies no definite position in the treatment of marsh fevers. Powerless 
in the treatment of smallpox, the salicylate of soda has not been suffi- 
ciently tried in typhoid fever. Its febrifuge power is exceedingly limited. 

"3. It is in acute articular rheumatism that the most certain and most 
prompt effects are observed — so much so that we may promise with 
almost certainty the cure of febrile or apyretic acute rheumatism within 
a space of from two to four days. Fifty-one cases may be adduced in 
proof of this. 

"4. In simple chronic rheumatism the trials which I have made have 
proved most satisfactory. The same maybe said of the acute crises 
which manifest themselves from time to time in simple rheumatism or 
in chronic rheumatic arthritis, the painful attacks of which cease as soon 
as in acute rheumatism. Moreover, the articular tumefactions consider- 
ably diminish, and the motions of the joints may become free even after 
years of pain, rigidity, and immobility — on the condition that the bony 
lesions have not become too deep-seated or too advanced. Twelve 
cases of chronic rheumatism either cured or ameliorated are adduced. 

"5. But it is in acute and chronic gout that the results are the most 
remarkable. From the commencement of my observations I was struck 
by the promptitude with which the most painful acute paroxysms were 
arrested. Within the space of two or three days the pains, the articular 
fluxion, the redness of the skin, and the sensibility to touch had all dis- 
appeared. Chronic gout is just as amenable to the salicylic treatment. 
Continued, even in moderate doses, it affords the patients absolute se- 
curity from an acute attack. The tophi of the joints diminish in size, 
and cease to become inflamed — in a word, the cure is complete, and 
that without the production of any metastasis to the heart, stomach, 
respiratory organs, or the brain. Not once have I been able, among 
the twenty-one cases I have watched, to observe the slightest retroces- 
sion of gout inwardly. No other inconvenience has been produced 
than the production of some disturbances in the ear, and sometimes a 
certain amount of debility or narcotism. The two latter phenomena 
disappear when the dose is diminished ; but the perturbations of audition 
are much more persistent. Among affections which are often of a 
gouty nature, gravel may be mentioned. This is favorably modified, 
or rather more easily eliminated, by the aid of salicylate of soda, which 
also has the advantage of allaying the nephritic pains. 

" 6. The salicylic treatment has seemed to be of advantage in certain 
facial neuralgias; but its action in this affection is not definitively estab- 
lished, and the same may be said with regard to sciatica. 

" 7. In painful affections of the spinal cord, the salicylate of soda 
produces calming effects which are distinctly appreciable; but by the 
continuance of its employment a certain amount of debility is pro- 
duced."]! 



SUMBUL 

Has antispasmodic properties, but is very rarely pre- 
scribed. 

1 [From the Monthly Abstract of Medical Science, Philadelphia, 
for September, 1 87 7.] 



368 LEECHES. 

TRIMETHYLAMINE AND ITS HYDRO- 
* CHLORATE. 

Lowering of temperature and pulse is said to follow 
the use of this drug, and it has been much recommended 
as a remedy for acute rheumatism. 

Dose of the hydrochlorate, 3 to 10 grains. 



LEECHES. 

\_Hirudo. Sanguisuga Officinalis.] 

Leeches are undoubtedly the most convenient means for 
the local abstraction of blood, and are used to relieve pain, 
which they do very effectually in certain local inflamma- 
tions, as pleicrisy, pericarditis, orchitis, iritis, hepatitis, 
peritonitis; and there is reason to believe that, when ap- 
plied sufficiently early, they may even moderate the 
inflammatory process. Their action, no doubt, may fre- 
quently be explained by direct vascular communication 
between superficial vessels and those of deeper parts. 

Each leech may contain about iyi dr. of blood, and 
subsequent fomentation may draw so much more from the 
skin as to raise the total amount up to half an ounce. 
Should the subsequent bleeding prove difficult of arrest, 
as sometimes happens, we may succeed in staunching the 
flow by means of pressure, cold, various astringents, the 
application of solid nitrate of silver, or the twisted suture. 
[The American only takes about y$ as much blood as the 
imported leech, and, on this account, is preferred by some 
in the treatment of diseases of children.] 

Special cautions in the use of leeches are — never to apply 
them, if possible, to any part over which firm pressure can- 
not subsequently be made, as the larynx; not to apply 
them in the evening, when, for some unexplained reason, 
the bleeding is more apt to be troublesome ; and, of course, 
never to allow their use in any victim of the hsemorrhagic 
diathesis. 

If leeches will not bite, we must smear the skin with 
cream or freshly-drawn blood, or immerse the animal itself 
in porter, which seems to have a stimulating effect ; and 
should one be unfortunately swallowed, we can kill it, and 
cause its expulsion from the stomach, by common salt. 



QUESTIONS. 

In submitting a series of questions to the consideration 
of the student, I have endeavored to place various sug- 
gestive points before him in interrogative form, and to 
approach the border line between practical medicine and 
therapeutics by introducing a few short illustrative cases. 
The principle seems to me worthy of further development, 
and a systematic collection of typical diseases, with varia- 
tions and exceptions and bed-side gleanings, might lead 
the way profitably up to those diffuse collections of symp- 
toms which are occasionally rolled into concrete form by 
our examining boards. 

It would not be difficult to expand my collection of que- 
ries to an almost unlimited extent ; but the conscientious 
attempt to answer those already constructed will at all 
events encourage the young reader to think for himself, 
and to emancipate his mind and memory from the ener- 
vating trammels of the more grinding forms of manuals. 



i. A child is under treatment for whooping-cough, and 
the mother states that after each dose of his medicine his 
face flushes, and he complains of his throat being very dry. 
What drug is most likely to produce these symptoms? 

2. Mention the different remedies to be employed in the 
various stages of syphilis. 

3. A case of acute eczema presents itself for treatment; 
there is much moist exudation, with smarting and tingling 
and almost erysipelatous redness. It is proposed to give 
arsenic. Would this meet with your approval, and what 
would be your line of practice? 

4. A patient comes to you in great alarm, thinking that 
he is paralysed, his legs feeling weak and heavy, and his 
gait becoming staggering. At the same time you observe 
a few pimples of acne on his forehead, and you learn that 
he has lately been suffering from sleeplessness. To what 
would your suspicions point as the cause of his symptoms? 



370 QUESTIONS. 

5. Give directions for disinfecting a room which has 
been occupied by scarlatinous patients. 

6. Mention a drug which seems to have a specific influ- 
ence over the poison of erysipelas, and write a prescrip- 
tion, with full directions for its use. 

7. Write a prescription for an effervescing draught con- 
taining carbonate of ammonia. 

8. Point out the error in the following prescription : — 

I£. Tinct. hyoscyami f 5 SS - 5 

Liq. potasses Ti|xx. ; 

Mucilaginis f 5j- ; 

Gentianae infusi f |j. 

Ter die. 

9. You are called to a very severe case of delirium 
tremens. It seems inadvisable to give opium, and chlo- 
ral has already failed. What course, therefore, would you 
pursue ? 

10. Mention the antidotes for prussic acid, strychnia, 
arsenic, and opium, with the general line of treatment to 
be pursued in a case of poisoning by each of these sub- 
stances. 

11. You are called to the following case. A middle- 
aged man has been known to suffer from heart-disease, 
and on applying your ear to his chest you hear a well- 
marked mitral-regurgitant bruit. His face is pale, with a 
tendency to lividity, his feet are beginning to swell, his 
pulse is weak and irregular, and does not accurately cor- 
respond to the beat of the heart, many of whose pulsations 
are not transmitted to the wrist. There are great anxiety 
and breathlessness, and ordinary stimulants have given only 
temporary relief. State your line of practice in such a 
case, and more especially the drug from which you would 
expect to derive speedy benefit. 

12. Mention the various drugs which have been of ser- 
vice in tetanus, with your opinion of their relative effi- 
ciency, and give the dose of each. 

13 Explain the action of the principal anaesthetic 
agents, and state which you consider to be most worthy of 
confidence. 

14. Mention the remedies which act on the pupil, and 
divide them into those which act locally and constitutionally. 

15. What is the advantage of the following prescrip- 
tion ? — 



QUESTIONS. 371 

I£. Tincturae opii TlXx. ; 

Acidi sulphurici diluti Tr\_xx. ; 

Decocti hsematoxyli f^j. M. 
Ter die sumend. 

16. Write a soothing cough-medicine for a case of phthisis, 
and include chlorate of potash and morphia. Dose, one 
teaspoonful. 

17. State the general treatment of a case of chorea, with 
the principal drugs which have been found useful, and 
give your opinion of their respective merits. 

18. What are the indications by which we know that 
conium, arsenic, and strychnia are beginning to produce 
their physiological effects ? 

19. Mention those drugs which are most readily absorb- 
ed through the unbroken cuticle. 

20. Enumerate the principal cholagogue cathartics. 

21. State the principal differences between the action of 
opium and morphia. 

22. You are called to see a case of severe sprained 
ankle, and hear that a friend is about to apply tincture of 
arnica. On inquiry you find that this remedy has never 
been used to this patient before. Would you sanction the 
treatment ? 

23. Enumerate those drugs which stimulate, and those 
which depress, the action of the heart. 

24. State which drugs are most worthy of confidence in 
cases of neuralgia of the fifth nerve. 

25. A patient presents himself with the following symp- 
toms : Constipation and violent colicky pain in the belly, 
some loss of power in the extensor muscles of the arms, 
a bluish line along the margin of the gums, and anaemia. 
What is the cause of, and the proper treatment for, his com- 
plaint; and what prophylactic means would you recommend 
him to adopt ? 

26. Mention the various means of lowering the bodily 
temperature in health and disease, and explain their action, 
more especially enumerating those remedies which act 
only in conditions of pyrexia. 

27. You have been attending a case of rheumatic fever, 
and all has gone on well until you are told one morning that 
the patient has had a disturbed night, has been restless and 
delirious, but that at the same time, the pain in the joints 
has subsided. You find him looking dull, confused, and 



37 2 QUESTIONS. 

only partially conscious. The temperature registers 105 , 
and in another hour has gone up to 106 . What treat- 
ment would you advise? 

28. State the principal dangers to be anticipated in 
chloroform administration, with their appropriate remedies. 

29. Mention the unpleasant effects which sometimes 
follow the use of quinine. 

30. What do you mean by ' accumulation' in therapeu- 
tics? 

31. A young married woman comes to ask relief for 
troublesome sickness and vomiting, recurring at intervals 
throughout the day, but always worse on first rising in the 
morning. What would you advise in the way of treat- 
ment, and how can you explain her symptoms ? 

32. Write a prescription for an alkaline lotion in a 
case of acute eczema. 

33. Mention the best narcotics to be used under the 
following circumstances : — 

1. Sleeplessness from overwork or worry. 

2. Delirium tremens. 

3. The fierce delirium of typhus. 

4. Acute mania. 

34. Write a prescription for iron in combination with 
potassium iodide and a vegetable bitter. 

35. Mention the various drugs which produce eruptions 
on the skin, and describe the forms of eruption produced. 

36. Mention the drugs which impart a peculiar color to 
the urine, with the varieties of tint produced. 

37. Contrast the paralysing effects of conium, Calabar 
bean, and veratria. 

38. State the physiological phenomena which may follow 
comparatively small doses of quinine, potassium iodide, 
potassium bromide, chloral, and mercury. 

39. State what you mean by a refrigerant. 

40. You are called to see a patient in an advanced stage 
of phthisis, in whom the night-sweats are causing serious 
exhaustion. All astringent remedies having failed, what 
drug would you recommend to be employed, and in what 
doses? 

41. A patient is seized with acute tonsillitis, and it is of 
great importance that he should recover his voice in a 
short time. Mention a drug which you might prescribe 
with good hopes of speedy benefit. 



questions. 373 

42. An elderly man is attacked with acute bronchitis, 
the cough and dyspnoea being urgent, and the sputa 
brought up with difficulty. The blood is beginning to 
be imperfectly aerated, the skin looking dusky and the lips 
blue, and although he is occasionally drowsy by day, he 
can obtain no sleep in the night from the constant and 
irritating cough. His family are much distressed at this 
insomnia, and having persuaded the doctor to give him 
something to make him sleep, a full dose of opium is 
ordered. State the probable result of this line of practice. 

43. You are summoned to see a case of ague. The 
patient cannot take bark or quinine in any form. What 
drug would you recommend in their place? 

44. A case of diarrhoea presents itself, characterised by 
furred tongue, cramping pains in the abdomen, sickness, 
and tenesmus, with the expulsion of rather scanty but thin 
and frequent evacuations. It is proposed to arrest this by 
means of astringents. State whether this treatment would 
meet with your approval, and what your own plan would 
be. 

45. You are called to a bad case of haemoptysis — all 
the usual astringents and styptics have failed. What drug 
would you recommend, and how would you administer it? 

46. State the best remedies for nocturnal incontinence 
of urine. 

47. Mention the principal medicines used for hypo- 
dermic injection, and the mode of performing the opera- 
tion. 

48. Give instances of toleration of drugs. 

49. Describe your treatment of purpura hsemorrhagica. 

50. State the rules which would guide you in prescribing 
acids and alkalies in dyspepsia. 

51. Write a prescription for a lotion containing hydro- 
cyanic acid. 

52. Mention the uncomfortable effects sometimes result- 
ing from the subcutaneous injection of morphia, and sug- 
gest some means for obviating them. 

53. Have any bad effects been recorded as following 
the subcutaneous injection of quinine ? 

54. You are called to a case of diarrhoea in which the 
motions are largely composed of blood and mucus, and 
much pain and tenesmus follow each evacuation of the 

32 



374 QUESTIONS. 

bowels. Ordinary astringents having failed, what special 
drug would you advise ? 

55. Give proof of the rapid absorption of drugs into the 
blood. 

56. Give instances of the different, and even opposite, 
effects of drugs in large and in small doses. 

57. Mention drugs which check, and others which pro- 
mote, the salivary secretion. 

58. Mention appropriate remedies for migraine. 

59. Mention those drugs which depress, and those which 
excite, the action of the spinal cord. 

60. Which preparation of conium is most deserving of 
confidence, and in what dose should it be given ? 

61. Which diuretics act more especially by influencing 
the renal circulation ? 

62. Mention those drugs which destroy, and those which 
aid in the construction of, the red corpuscles of the blood. 

63. Have any drugs the power of raising the tempera- 
ture of the body? 

64. Enumerate the secondary action of emetics, and 
explain them physiologically. 



THERAPEUTIC SUGGESTIONS ; 

OR, 

INDEX OF DISEASES 



Abscesses 

belladonna, 125 

carbolic acid, 65 

cod liver oil, 263 

flaxseed poultice, 247 

ice, 113 

iodine, 236 
Acne faciei 

arsenic, 1 19 

sulphur, 335 
Acute mania 

bromide of potassium, 304 

chloral, 155 

dulcamara, 199 

hyoscyamus, 234 

Indian hemp, 142 

opium, 272 
After-pains (see Labor) 
Ague 

apiol, 364 

arsenic, 1 18 

quinia, 175 
Ague-cake (see Spleen, enlarged) 
Albuminuria (see Bright's disease) 
Amaurosis 

strychnia, 259 
Amenorrhcea 

aloes, 96 

apiol, 364 

cantharides, 145 

catnep, 15 1 

ergot, 203 

guaiac, 222 

hiera picra, 141 

iron, 208 

marjoram, 280 

myrrh, 258 

pennyroyal, 223 

rue, 315 



Amenorrhcea — 

savin, 317 

turpentine, 344 
Anaemia 

cod-liver oil, 263 

iron, 208, 210 

solution of dialysed iron, 363 

(See also Pernicious anaemia and 
Leucocythemia) 
Aneurism 

ergot, 202 

iodide of potassium, 306 
Angina (see Sore throat) 
Angina pectoris 

opium, 274 

hypodermic injection of mor- 
phia, 278 

nitrite of amyl, 93 
Animal poisoning (see Poisoning) 
Aphthous sore mouth 

borax, 332 

chlorate of potassium, 299 

sulphite of sodium, 332 

sulphurous acid, 337 
Apoplexy 

croton oil, 268 
Arsenical poisoning (see Poison- 
ing) 
Ascarides (see Worms) 
Ascites (see Dropsy) 
Asthma 

antimony, 108 

arsenic, 118 

belladonna, 128 

chloral, 155 

chloroform, 164 

cod-liver oil, 263 

ether, 82 

eucalyptus globulus, 356 

(375) 



376 



INDEX OF DISEASES. 



Asthma — 

lobelia, 249, 250 

nitrite of amyl, 93 

opium, 274 

pepsin, 364 

pilocarpin, 360 

potassium-nitrate papers, 301 

stramonium, 335 

tobacco-smoking, 341 

turpentine stupes, 344 
Atheroma 

digitalis, 197 

Biliary colic (see Gall-stones) 
Biliousness 

acids, 41 

blue pill, 228 

nitro-muriatic acid, 75 

ipecacuanha, 240 

(See Hepatic disorders) 
Bites 

caustic potassa, 298 

nitrate of silver, 1 15 

(See also Animal poisoning) 
Bladder affections (see Cystitis) 
Boils (see Abscesses) 
Bowel affections (see Diarrhoea 

and Constipation) 
Brain affections 

blisters, 145 

bromide of potassium, 303 

iodide of potassium, 305 

(See also Meningitis and Syphilis) 
Brain softening 

phosphorus, 282 
Bright's disease 

alkalies, 300 

compound jalap powder, 241 

cream of tartar, 302 

diaphoretics, 49 

gallic acid, 214 

iron, 209 

jaborandi, 357 

pilocarpin, 360 

pipsissewa, 153 

potash salts, 300 

scoparius, 326 

water, 50 
Bronchitis 

ammonia, 100, 102 

ammoniac, 99 

antimony, 108 



Bronchitis — 

arsenic, 118 

assafcetida, 122 

balsam of Peru, 123 

benzoin, 132 

chloride of ammonium, 102 

cimicifuga, 169 

cod-liver oil, 263 

copaiba, 188 

cubebs, 191 

digitalis, 197 

eucalyptus, 356 

garlic, 94 

iodide of potassium, 307 

ipecacuanha, 238 

lobelia, 250 

myrrh, 258 

oil of amber, 267 

opium, 277 

seneka, 327 

squill, 325 

steam, 113 

tar, 290 

tartar emetic, 20 

turpentine, 345 

turpentine stupes, 344 

wild-cherry bark, 310 
Bronchocele (see Goitre) 
Broncho-pneumonia 

antimony, 108 

(See Bronchitis) 
Bubo 

ice, 113 

iodoform, 237 

(See also Abscesses) 
Burns 

carbolic acid, 64 

carbonate of lead, 292 

carron oil, 137, 247 

collodion, 220 

cotton, 220 

lime, 137 

warm bath, 112 

Calculus (phosphatic) 

nitric acid, 74 

potassa, 300 

(See also Gravel) 
Cancer 

acetic acid, 63 

arsenic, 117 

blood-root, 319 



INDEX OF DISEASES. 



377 



Cancer — 

chloride of zinc, 352 

chloroform, 166 

citric acid, 68 

iodoform, 237 

opium, 273 
Cancrum oris 

nitric acid, 74 
Carbuncles 

tr. iodine, 236 

(See Abscesses) 
Cardiac disease (see Heart disease) 
Cardiac dropsy (see Dropsy) 
Cardiac palpitation (see Heart dis- 
ease) 
Caries 

cod-liver oil, 264 

sulphuric acid, 339 
Catarrh (see Coryza) 
Catarrh (chronic) 

assafcetida, 122 

(See also Coryza) 
Cerebral disorders (see Brain 

affections) 
Chafing (see Excoriation) 
Chancre (see Syphilis) 
Chapped hands 

collodion, 274 

glycerine, 218 
Chilblains 

tr. iodine, 236 
Chills and fever (see Ague) 
Chloasma 

sulphurous acid, 337 

(See also Skin disease) 
Chlorosis 

solution of dialysed iron, 363 

(See also Anaemia) 
Cholera 

cajuput oil, 136 

camphor, 140 

hypodermic injections of mor- 
phia, 278 

nitrite of amyl, 94 

sulphuric acid, 339 
Cholera infantum (see Diarrhoea) 
Cholera morbus 

acetate of lead, 293 

opium, 274 

(See also Diarrhoea) 
Chordee 

camphor, 141 

3 



Chorea 

arsenic, 1 18 

bromide of potassium, 304 

bromide of iron, 208 

cimicifuga, 169 

chloral, 155 

chloroform, 166 

conium, 184 

cold affusion, 112 

copper, 192 

ether, 82 

hemlock, 184 

iron, 208 

oxide of zinc, 352 

physostigma, 285 

manganesium sulphate, 253 

sulphate of zinc, 352 
Chronic mania 

cimicifuga, 170 

cod-liver oil, 263 

ergot, 201 

hemlock, 185 
Chronic nephritis (see Blight's 

disease) 
Colds (see Coryza) 
Colic 

assafoetida, 122 

belladonna, 130 

cajuput oil, 136 

catnep, 151 

chloroform, 164 

cloves, 150 

ether, 82 

fennel tea, 212 

ginger, 354 

oleum monardae, 256 

mustard, 329 

opium, 273 

pennyroyal, 223 

warm bath, 112 
Colica pictonum (see Painter's 

colic) 
Color-blindness 

santonin, 320 
Condylomata 

black-wash, 226 

carbolic acid, 64 

chromic acid, 68 

(See also Syphilis) 
Congestion of brain 

compound jalap powder, 242 

elaterium, 200 
>* 



378 



INDEX OF DISEASES 



Congestion of spinal cord 

ergot, 20 1 
Conjunctivitis 

alum, 97 

atropia, 126 

cod-liver oil, 264 

silver nitrate, 115 

sulphate of zinc, 352 
Constipation 

aloes, 96 

alum, 98 

assafcetida, 122 

belladonna, 129 

castor oil, 266 

colocynth, 183 

croton oil, 269 

gamboge, 215 

jalap, 242 

juglans, 242 

lead, 293 

nux vomica, 261 

podophyllum, 295 

senna, 328 

strychnia, 260 
Consumption (see Phthisis) 
Convulsions, epileptic (see Epi- 
lepsy) 
Convulsions, hysterical (see Hys- 
teria) 
Convulsions, infantile 

assafcetida, 122 

bromide of potassium, 303 

chloral, 155 

chloroform, 166 

ether, 82 

garlic, 94 

hemlock, 184 

mustard baths, 330 

oil of amber, 267 

warm bath, 112 
Convulsions, puerperal 

chloral, 156 

chloroform, 166 
Convulsions, uraemic (see Ursemic 

coma) 
Corneal ulcer 

black-wash, 226 
Corns 

acetic acid, 63 
(See Warts) 
Coryza 

aconite, 79 



Coryza — 

alcohol, 88 

assafcetida, 122 
. boneset tea, 204 

camphor, 140 

creasote, 190 

cubebs, 191 

Dover's powder, 277 

glycerite of tannin, 213 

horehound, 254 

licorice, 219 

opium, 274 
Cough, spasmodic 

belladonna, 130 

chloroform, 164 

gelsemium, 217 
Cracked nipples 

benzoin, 132 

flexible collodion, 221 

tannic acid, 213 
Croup, pseudo-membranous 

alum, 98 

antimony, 108 

chlorate of potash, 299 

ipecacuanha, 238 

lactic acid, 73 

lime-water, 137 

mercury, 229 

steam, 113 

(See also Diphtheria and Spasm 
of the larynx) 
Cystitis 

buchu, 135 

copaiba, 188 

cubebs, 191 

hyoscyamus, 23 

iron, 259 

juniper, 243 

pareira, 281 

turpentine, 345 

uva ursi, 348 

Debility 

alcohol, 89 

cod-liver oil, 263 

iron, 208, 363 

phosphorus, 281 

quinia, 173 

strychnia, 259 

(See also Anaemia) 
Delirium tremens 

antimony, 108 



INDEX OF DISEASES 



379 



Delirium tremens — 

bromide of potassium, 304 

chloral, 155 

digitalis, 24, 194 

lupulin, 224 

musk, 256 

opium, 272 

veratrum viride, 350 
Diabetes 

almonds, 105 

bromide of potassium, 304 

glycerine, 218 

opium, 275 

phosphoric acid, 285 

yeast, 206 
Diabetes insipidus 

ergot, 201 

jaborandi, 358 

opium, 275 
Diarrhoea 

acetate of lead, 293 

alum, 97 

arsenic, 1 18 

bismuth, 133 

blackberry, 315 

cajuput oil, 136 

camphor, 141 

Castillon's powders, 346 

castor oil, 266 

catechu, 151 

cinnamon, 180 

copper, 192 

ergot, 202 

geranium, 218 

gum arabic, 62 

ipecacuanha, 240 

kino, 243 

licorice, 219 

lime-water, 138 

logwood, 222 

nitrate of iron, 209 

opium, 274 

ox-bile, 357 

oxide of zinc, 353 

pepsin, 363 

podophyllum, 295 

rhatany, 244 

rhubarb, 313 

sulphuric acid, 339 

tannic acid, 213 

turpentine, 344 



Diphtheria 

ammonia, 1 01 

carbolic acid, 64 

chlorate of potassa, 302 

chlorine water, 161 

chromic acid, 68 

citric acid, 68 

ipecacuanha, 239 

lactic acid, 73 

lime inhalations, 137 

muriatic acid, 163 

tincture of iron, 207 
Diphtheritic croup 

chlorate of potassa, 302 
Diphtheritic paralysis 

strychnia, 260 
Dislocations 

chloroform, 166 

hemlock, 185 
Drink-craving 

tincture of capsicum, 147 
Dropsy 

blisters, 145 

colocynth, 182 

comp. jalap powder, 242 

copaiba, 188 

cream of tartar, 300 

digitalis, 197 

elaterium, 200 

gamboge, 215 

infusion of erigeron, 204 

juniper, 243 

pilocarpin, 360 

potash salts, 300 

scoparius, 326 

squill, 325 

spirits of nitre, 91 
Dysentery 

ergot, 202 

gum arabic, 62 

Indian bael, 356 

ipecacuanha, 240 

opium, 274 

rhatany, 244 
Dyspepsia 

acids, 40 

aloes, 96 

arsenic, 1 18 

assafostida, 121 

belladonna, 130 

bismuth, 133 

carbolic acid, 67 



3 8o 



INDEX OF DISEASES. 



Dyspepsia — 
chamomile, 106 
charcoal, 147 
columbo, 138 
ether, 82 ' 
emetics, 52 
gentian, 218 
hydrocyanic acid, 70 
lactic acid, 73 
lime water, 138 
magnesia, 251 
muriatic acid, 162 
mix vomica, 260 
ox-bile, 357 
pepsin, 363 
quassia, 31 1 
quinia, 173 
rhubarb, 313 
senna, 328 
soda, 332 
soda-mint, 333 
sulphurous acid, 338 
sulphate of manganese, 253 
taraxacum, 343 
thoroughwort, 204 

Eczema 

arsenic,. 119 

bicarbonate of potassium, 298 

glycerite of tannic acid, 214 

hydrocyanic acid, 70 

lead-water, 292 

soda, 332 

(See also Skin diseases) 
Empyema 

tr. iodine, 237 
Epilepsy 

bromide of ammonium, 104 

bromide of potassium, 303 

Calabar bean, 286 

copper, 192 

nitrite of amyl, 92 

oxide of zinc, 352 

physostigma, 285 

silver, 116 
Epistaxis 

ergot, 201 

(See Haemorrhage) 
Erysipelas 

aconite, 79 

carbolic acid, 65 

collodion, 220 



Erysipelas — 

elm-poultice, 347 

lead-water, 292 

liquor gutta-perchae, 222 

quinia, 171 

sulphate of iron, 208 

tincture of iron, 209 
Excoriations 

bismuth, 133 

chalk, 137 

lycopodium, 251 

starch, 105 

(See Skin diseases) 

Facial neuralgia 

gelsemium, 216 

(See also Neuralgia) 
Fainting (see Syncope) 
Favus 

black-wash, 226 

(See Skin disease) 
Felon 

carbolic acid, 65 

nitrate of silver, 115 
Fetid expectoration 

creasote, 190 

salicylic acid, 365 
Fever, intermittent (see Ague) 

(See also Typhus, Typhoid) 
Fevers 

aconite, 79 

effervescing draughts, 68 

gum arabic, 62 

quinia, 175 

salicylic acid, 366 

vinegar, 62 

yeast, 206 
Fissure of rectum 

belladonna, 125 
Flatulence 

carbolic acid, 67 

charcoal, 147 

ether, 82 
.soda-mint, 333 

(See also Dyspepsia) 
Flooding, post-partum 

ergot, 203 

iron injections, 207 

(See also Haemorrhages) 

Gall-stones 

belladonna, 129 



INDEX OF DISEASES 



38l 



Gall-stones — 

chloroform, 166 

hypodermic injections of mor- 
phia, 278 

opium, 273 

warm bath, 112 
Gastralgia 

blisters, 144 

manganesium sulphate, 253 

(See also Colic) 
Gastro- enteric inflammation 

gum arabic, 62 

(See also Diarrhoea and Dysen- 
tery) 
Glandular enlargements 

cod-liver oil, 264 

(See also Scrofula) 
Gleet 

copper sulphate, 192 

iron, 209 

storax, 335 

turpentine, 345 

(See also Gonorrhoea) 
Goitre 

biniodide of mercury, 226 

tincture of iodine, 237 
Gonorrhoea 

alum, 97 

bismuth, 133 

buchu, 134 

copaiba, 187, 189 

cubebs, 191 

fluid extract of matico,. 254 

hydrastis Canadensis, 233 

infusion of pomegranate, 3 1 1 

silver nitrate, 1 15 

storax, 335 

sulphate of zinc, 352 

sulphate of copper, 192 

tannic acid, 213 

turpentine, 345 
Gout 

colchicum, 181 

iodide of potassium, 307 

lithium, 248 

potash, 299 

salicylic acid, 367 
Granular lids 

sulphate of copper, 192 
Gravel 

lithia, 248 

salicylate of soda, 367, 



Haematemesis 

gallic acid, 214 

(See also Haemorrhage) 
Haematuria 

turpentine, 344 
Haemoptysis 

acetate of lead, 293 

alum, 98 

digitalis, 196 

ergot, 201 

gallic acid, 214 
Haemorrhage 

alum, 98 

ergot, 201 

ice, 113 

iron, 207 

matico, 254 

opium, 274 

tannic acid, 213 

turpentine, 344 

(See also Menorrhagia, etc.) 
Haemorrhoids 

belladonna, 125 

charcoal, 148 

ergot, 201 

iodoform, 237 

ointment of galls, 214 

nitric acid, 74 

pepper, 289 

sulphur, 336 
Hay-asthma or Hay-fever 

arsenic -, 118 

quinia, 174 
Headache 

aconite, 78 

podophyllum, 295 

valerian, 348 

valerianate of ammonia, 349 

vinegar, 62 

(See also Neuralgia) 
Heartburn 

magnesia, 251 

(See also Dyspepsia) 
Heart-clot 

ammonia, IOI 
Heart-disease 

aconite, 79 

belladonna, 127 

chloroform, 164 

comp. jalap powder, 242 

digitalis, 195-199 

hydrocyanic acid, 70 



382 



INDEX OF DISEASES. 



Heart-disease — 

morphia, 274 

potash-salts, 300 

veratrum viride, 350 
Hepatic disorders 

blue pill, 228 

citric acid, 68 

ipecacuanha, 240 

leeches, 368 

nitric acid, 74 

nitro-muriatic acid, 75 

podophyllum, 295 

rhubarb, 314 

sodium bicarbonate, 332 
Hernia 

chloroform, 166 

hemlock, 185 

warm bath, 112 
Herpes zoster 

collodion, 220 

(See Skin disease) 
Hiccough 

musk, 256 

oil of amber, 267 
Hydrocele 

tr. iodine, 236 
Hydrothorax 

pilocarpin, 360 

(See also Pleurisy) 
Hypochondriasis 

cimicifuga, 170 

(See Acute and Chronic mania) 
Hysteria 

assafoetida, 121 

catnep, 151 

chloroform, 164 

cloves, 150 

cold water, 112 

ether, 82 

hemlock, 185 

musk, 256 

oil of amber, 267 

valerian, 348 

valerianate of zinc, 349 
Hysterical convulsions 

musk, 256 

Impetigo 

arsenic, 119 

(See Skin disease) 
Impotence 

phosphorus, 281 



Incontinence of urine 

belladonna, 21, 128 

bromide of potassium, 304 

buchu, 135 

chloral, 155 

collodion, 221 

ergot, 202 

santonin, 321 

strychnia, 259 
Indigestion (see Dyspepsia) 
Infantile convulsions (see Convul- 
sions, infantile) 
Insanity (see Acute and Chronic 

mania) 
Insomnia 

chloral, 154 

opium, 271 
Intertrigo 

bismuth, 133 

(See Excoriation) 
Iritis 

atropia, 126 

blisters, 144 

leeches, 368 

turpentine, 345 
Irritable heart 

belladonna, 127 

chloroform, 164 

hydrocyanic acid, 70 

(See also Heart disease) 
Irritable stomach 

calomel, 20 

effervescing draught, 68 

grey powder, 20 

(See also Vomiting) 
Itch (see Scabies) 



Jaundice 

podophyllum, 295 

rhubarb, 314 

soda, 332 

(See also Hepatic disorder) 
Joint-affections 

blisters, 145 

cod-liver oil, 264 

mercurial ointment, 226 



Kidney-complaint 
pipsissewa, 153 
(See Bright's disease) 



INDEX OF DISEASES. 



383 



Labor 

chloral, 155 

cotton-root bark, 220 

ergot, 207 

opium, 273 

quinia, 171 
Laryngismus stridulus (see Spasm 

of the larynx) 
Leprosy 

copaiba, 187 

(See Skin diseases) 
Leucocythemia 

phosphorus, 283 

(See also Anaemia) 
Leucorrhoea 

alum, 97 

bicarbonate of potassium, 298 

bismuth, 133 

ergot, 203 

fluid extract matico, 254 

iron injections, 207 

lime-water, 137 

sulphate of zinc, 352 

tannic acid, 213 

white-oak bark, 312 
Lichen 

arsenic, 119 

(See Skin diseases) 
Liver disease (see Hepatic dis- 
orders) 
Lumbago (see Myalgia) 
Lumbricoids (see Worms) 
Lupus 

carbolic acid, 65 

copaiba, 187 

(See Skin diseases) 



Malarial fevers 

quinia, 175 

(See Ague) 
Mania (see Acute mania) 
Mastitis 

belladonna, 130 
Mastodynia 

belladonna, 130 
Measles 

phosphorus, 283 
Meningitis 

blisters, 145 

ice, 113 

opium, 272 



Menorrhagia 

bromide of potassium, 304 

cinnamon, 180 

digitalis, 196 

ergot, 201 

gallic acid, 214 

oil of erigeron, 204 

oxide of silver, 116 

(See also Haemorrhage) 
Migraine (see Neuralgia) 
Mitral disease (see Heart disease) 
Myalgia 

ammonia, 101 

atropia injections, 130 

cimicifuga, 170 

conium, 185 

gelsemium, 216 

morphia injections, 278 

mustard plasters, 329 
Myelitis, chronic 

belladonna, 128 

Narcotic poisoning 

blisters, 145 

(See also Poisoning) 
Nervous debility 

phosphorus, 281 

(See also Debility) 
Nervous exhaustion 

strychnia, 259 
Nervous headache 

valerianate of ammonium, 349 

valerian, 348 

(See also Headache) 
Nervous insomnia 

chloral, 154 

(See also Insomnia) 
Nervousness 

assafcetida, 122 

(See Hysteria) 
Neuralgia 

aconite, 77, 78 

alcohol, 85 

ammonia, 10 1 

ammonium chloride, 103 

arsenic, 118 

belladonna, 125 

blisters, 144 

cannabis Indica, 142 

chloral, 154 

chloral-camphor, 159 

chloroform, 164 



3§4 



INDEX OF DISEASES. 



Neuralgia — 

cochineal, 1 80 

cod-liver oil, 262 

croton-chloral, 160 

ergot, 201 

ether, 82 

guarana, 136 

gelsemium, 216 

hydrocyanic acid, 70 

hypodermic injections of mor- 
phia, 278 

Indian hemp, 142 

iodoform, 237 

iron, 208 

mustard plaster, 329 

nitrite of amyl, 92 

opium, 273 

quassia, 173 

salicylic acid, 367 

turpentine stupes, 344 

valerianate of quinia, 349 

veratria ointment, 316 

(See also Headache, Toothache, 
Myalgia, and Pleurodynia) 
Night sweats 

acetic acid, 63 

atropia, 129 

ergot, 201 

oxide of zinc, 353 

quinia, 173 

sulphuric acid, 339 
Nipples, sore (see Cracked nipples) 

(Edema (See Dropsy) 
CEdema of glottis 

chromic acid, 68 
Onychia maligna 

nitrate of lead, 292 
Ophthalmia (see Conjunctivitis) 
Ophthalmology 

atropia in, 126 
Orchitis 

ice, 113 

leeches, 368 
Otorrhcea 

glycerite of tannic acid, 214 
Oxyuris vermicularis (see Worms) 
Ozaena 

creasote, 190 

glycerite of tannic acid, 214 

potassium permanganate, 298 

(See also Coryza) 



Painters' colic 

alum, 97 

belladonna, 129 

chloroform, 166 

Epsom salt, 252 

iodide of potassium, 307 

sulphuric acid, 336 
Palpitation of the heart 

chloroform, 164 

digitalis, 1 15 

hydrocyanic acid, 70 

(See also Heart disease) 
Paralysis 

ergot, 207 

strychnia, 259 
Paralysis agitans 

hemlock, 185 
Paralysis of the insane 

physostigma, 286 
Paraplegia (see Paralysis) 
Parturition (see Labor) 
Pediculi 

black wash, 226 
Pemphigus 

arsenic, 1 19 
Pericarditis 

blisters, 145 

leeches, 368 
" mercury, 229 
Periodical affections 

quinia, 175 

(See Ague) 
Periostitis 

iodide of potassium, 307 
Peritonitis 

aconite, 79 

blisters, 145 

flaxseed poultices, 247 

leeches, 368 

mercury, 229 

mustard, 329 

opium, 274 

turpentine stupes, 344 
Pernicious anaemia 

phosphorus, 283 

(See also Anaemia) 
Phagedena 

chromic acid, 68 

iron, 208 

nitric acid, 74 
Phthisis 

chloral, 155 



INDEX OF DISEASES 



385 



Phthisis — 

cod-liver oil, 263 

hypophosphite of lime, 138 

opium, 274 

oxalic acid, 75 

wild-cherry bark, 310 
Piles (see Haemorrhoids) 
Pleurisy 

aconite, 79 

blisters, 144 

mercury, 229 

mustard, 329 

pilocarpin, 360 

turpentine stupes, 344 
Pleurodynia 

blisters, 144 

mustard, 329 

(See also Neuralgia) 
Pneumonia 

aconite, 79 

ammonia, 100-102 

antimony, 108 

blisters, 145 

diaphoretics, 49 

flaxseed poultices, 248 

mercury, 229 

mustard, 329 

opium, 274 

quinia, 172 

senega, 327 

turpentine stupes, 344 

veratrum viride, 350 
Poisons and Antidotes (for general 
remarks on Antidotes see page 

37) 

Acid poisoning, treatment of, 42 
Aconite poisoning, treatm't of, 77 

chloral, 148 
Alcohol poisoning, treatment of, 
84 
ammonia, 100 
Alkaline poisoning (see Ammo- 
nia, Potassa, etc.) 
Ammonia poisoning, treat., 102 

acids, 101 
Amylic-alcohol poisoning, treat- 
ment of, 91 
Animal poisoning (bites, stings, 
etc.), treatment of, 38 
alcohol, 85 
ammonia, 1 00 
liquor potassae, 38 

33 



Poisons and Antidotes — 

Antimonial poisoning, treat, of, 

109 (see Tartar emetic poi- 

' soning ) 

Arsenical poisoning, treatm't of, 

117-119 

hydrated sesquioxide of iron, 

liquor ferri dialysatus, 362 

saccharated sesquiox. iron, 119 
Belladonna poisoning, treatment 
of, 124-131 

Calabar bean, 288 

charcoal, 124 

opium, 271 

tannin, 124 

tartar emetic, 109 
Bitter almonds, 105 

(See Hydrocyanic acid) 
Calabar-bean poisoning, treatm't 
of, 288 

alcohol, 84 

atropia, 285 

strychnia, 259 
Carbolic acid poisoning, treatm't 

of, 67 _ 
Chloral poisoning, treatment of, 

I54-I57 . 
Chloroform poisoning, treatment 
of, 163-166 

nitrite of amyl, 92 
Conium poisoning, treat, of, 186 

atropia, 183 

stimulants, 87, 100 
Copper poisoning, treat, of, 192 

albumen, 191 

ferrocyanide of potassium, 191 
Corrosive sublimate poisoning, 
treat, of (see Mercurial poi- 
soning) 
Hydrocyanic acid poison'g, treat- 
ment of, 71 

cold affusions, ^8 
Iodine poisoning, tream't of, 335 

starch, 335 
Lead poisoning, treatment of, 292 

alum, 291 

Epsom salts, 252 

iodide of potassium, 307 

sulphuric acid, 336 
Lobelia poisoning, treat, of, 249 
Malarial poisoning (see Ague) 



3 86 



INDEX OF DISEASES. 



Poisons and Antidotes — 
Mercurial poisoning, 225 

albumen, 225 

chlorate of potassium, 299 

gold leaf and iron filings, 225 
Narcotic poisoning, treat, of, 38 

alcohol, 87 

ammonia, 100 

apomorphia injections, 53, 280 

atropia, 38 

blisters, 145 

caffeine, 136 

charcoal, 148 

electricity, 270 

emetia injections, 53, 241 

emetics, 37, 270 

mustard, 330 

stimulants, ^8 

stomach-pump, ^y 

sulphate of copper, 192 

sulphate of zinc, 352 
Opium poisoning, treat, of, 271 

belladonna, 271 

(See also Narcotic poisoning) 
Oxalic acid poisoning, treatment 

of, 75 
chalk, 137 
magnesia, 75 
Phosphorus poisoning, treat, of, 
281 
magnesia, 251 
oil of turpentine, 345 
Physostigma poisoning (see Cal- 
abar bean poisoning) 
Prussic acid poisoning (see Hy- 
drocyanic acid poisoning) 
Rhus toxicodendron poisoning, 
treatment of, 38 
alkalies, 37 

infusion of lobelia, 250 
sweet spirits of nitre, 91 
Snake poison (see Animal poi- 
soning) 
Strychnia poisoning, 259—261 
anaesthetics, 261 
bromide of potassium, 259 
chamomile, 106 
charcoal, 148 
chloral, 259 
chlorine, 161 
nicotia, 259 
nitrite of amyl, 92 



Poisons and Antidotes — 

Strychnia poisoning — 
oleum anthemidis, 106 
physostigma, 288 
tannic acid, 213 

Tartar-emetic poisoning, treatm't 
of, 107 
coffee, 107 
stimulants, 107 
tannic acid, 109, 214 
tea, 107 

Tobacco poisoning, treat, of, 340 

Veratria poisoning, treat, of, 316 
Polypi, uterine 

ergot, 203 

(See also Menorrhagia) 
Polyuria (see Diabetes insipidus) 
Priapism 

bromide of potassium, 304 

camphor, 141 
Prolapsus ani 

bismuth, 133 
Prurigo 

hydrocyanic acid, 70 

soda, 332 

(See also Skin diseases) 
Psoriasis 

arsenic, 1 19 

chrysophanic acid, 357 

copaiba, 186-188 

phosphorus, 282 

tar ointment, 290 
Puerperal convulsions (see Convul- 
sions) 
Pulmonary complaints 

Iceland moss, 153 

(See Phthisis, Pneumonia, and 
Pleurisy) 
Purpura 

ergot, 202 

turpentine, 344 

(See also Scurvy) 
Pyaemia 

alcohol, 84 

quinia, 172 
Pyelitis 

cantharides, 145 

turpentine, 345 
Pyrosis 

bismuth, 133 

manganesium sulphate, 253 

(See also Dyspepsia) 



INDEX OF DISEASES. 



387 



Quinsy (see Tonsillitis) 

Rachitis 

cod-liver oil, 264 

iron, 209 

phosphate of lime, 138 

phosphoric acid, 285 

phosphorus, 283 
Renal calculus 

warm bath, 1 12 

(See also Calculus) 
Rheumatism 

aconite, 79 

arsenic, 119 

belladonna, 125 

blisters, 144 

bromide of ammonium, 101 

chloral, 154 

cimicifuga, 170 

citric acid, 68 

cod-liver oil, 264 

dulcamara, 199 

guaiac, 222 

iodide of potassium, 305 

ipecacuanha, 241 

iron, 209 

lemon-juice, 246 

oil of cajuput, 136 

pilocarpin, 360 

pipsissewa, 153 

potassium bicarbonate, 298, 299 

quinia, 172 

salicin, 364 

salicylic acid, 365, 366 

sulphur, 336 

trimethylamine, 368 

(See also Myalgia) 
Rheumatoid arthritis 

arsenic, 119 
Rickets (see Rachitis) 
Ringworm 

acetic acid, 63 

(See also Skin disease) 
Rupture of bladder 

opium, 273 
Rupture of intestine 

opium, 273 
Rupture of uterus 

opium, 273 

Salivation 

belladonna, 129 



Salivation — 

chlorate of potash, 299 
Sarcinous vomiting 

carbolic acid, 67 

hyposulphite of soda, 332 
(See also Vomiting) 
Scabies 

arsenic, 120 

storax, 335 

sulphur ointment, 336 
Scarlet fever 

aconite, 79 

ammonia, 103 

antipyretics, 44 

belladonna, 129 

chlorate of potassium, 299 

chlorine water, 16 1 

phosphorus, 283 

quinia, 175 

rosemary, 334 
Sciatica 

atropia injections, 130 

blisters, 144 

hypodermic injections of mor- 
phia, 278 

mustard, 329 

opium, 273 

turpentine enema, 345 

(See also Neuralgia) 
Scrofula 

barium chloride, 124 

calcium chloride, 138 

cod-liver oil, 264 

camp, tinct. of iodine, 237 

iodine, 236 

iron, 209 

phosphoric acid, 285 

pipsissewa, 153 

stillingia, 334 
Scurvy 

chromic acid, 68 

citric acid, 68 

ergot, 202 

lemon-juice, 245 

oxalic acid, 75 

turpentine, 344 

vinegar and nitre, 62 
Sea-sickness 

bromide of potassium, 304 

chloral, 155 

chloroform, 164 
Sick-headache (see Headache) 



3 88 



INDEX OF DISEASES. 



Skin disease 

acetic acid, 63 

arsenic, 119 

bismuth, 133 

black-wash, 226 

cadmium salts, 136 

carbolic acid, 65 

chloroform, 164 

cod-liver oil, 264 

collodion, 220 

copaiba, 187 

creasote, 190 

dulcamara, 199 

Goa powder, 357 

hydrocyanic acid, 70 

hyposulphite of soda, 332 

lycopodium, 251 

nitrate of lead, 292 

oxide of zinc ointment, 352 

phosphorus, 282 

soda, carbonate of, 332 

starch, 105 

stillingia, 334 

sulphur baths, 336 

sulphurous acid, 337 

tar ointment, 290 

warm bath, 112 

(See Acne faciei, Eczema, Ery- 
sipelas, Excoriations, Favus, 
Herpes zoster, Impetigo, Lep- 
rosy, Lichen, Lupus, Onychia 
maligna, Pemphigus, Prurigo, 
Psoriasis, Ringworm, Scabies, 
Small-pox, and Tinea Tonsu- 
rans) 
Sloughing 

nitric acid, 74 
Smallpox 

alcohol, 87 

quinia, 175 
Smallpox pitting 

collodion, 220 

liquor gutta-perchse, 222 

mercurial ointment, 229 

silver nitrate, 115 
Snake-bite 

ammonia, 100 
Sore throat 

alum, 97 

chlorate of potash, 299 

compound infusion of roses, 315 
- glycerite of tannic acid, 213 



Sore throat — 

gum arable, 62 

iodoform, 237 

iron, 207 

rosemary, 334 

sage -tea, 319 

(See also Tonsillitis) 
Spasm of the larynx 

antimony, 108 

bromide of potassium, 303 

cold affusions, 112 

compound syrup of squill, 325 

conium, 185 
Spleen, enlarged 

bromide of potassium, 303 

fluid extract of ergot, 202 

quinia, 175 
Sprains and bruises 

laudanum, 271 

lead-water, 292 

vinegar, 62 
Stings of insects 

ammonia, 1 00 

(See Animal poisoning) 
Stomatitis, mercurial 

chromic acid, 68 

(See Mercurial poisoning) 
Stone in the bladder (see Calculus) 
Stricture, spasmodic 

hemlock, 185 

opium, 273 

warm bath, 112 
Stupor (see Uraemic coma and Nar- 
cotic poisoning) 
Suffocative catarrh 

garlic, 94 

(See Bronchitis) 
Summer complaint (see Diarrhoea) 
Sunburn 

vinegar, 62 
Suppurating glands (see Scrofula) 
Sweating 

acids, 39 

alum, 98 

atropia, 129 
Sweating of phthisis (see Night- 
sweats) 
Syncope 

ammonia, 100 
Syphilis 

bichromate of potassium, 302 

black-wash, 226 



INDEX OF DISEASES 



389 



Syphilis — 

chromic acid, 68 

cod-liver oil, 264 

corrosive-sublimate injections, 
231 

iodide of potassium, 305 

iron, 209, 210 

mercury, 229, 231 

nitric acid, 74 

sarsaparilla, 324 

stillingia, 334 

Zittmann's decoction, 232 
Syphilitic brain- disease 

mercury, 227 
Syphilitic sore throat 

black-wash, 226 

corrosive sublimate gargle, 231 
Syphilitic ulcer 

iodoform, 237 

sulphuric acid, 339 



Taenia (see Worms) 
Tapeworm (see Worms) 
Tetanus 

bromide of potassium, 303 

cannabis Indica, 142 

chloral, 156 

conium, 185 

gelsemium, 217 

nitrite of amyl, 92 

physostigma, 286 

tobacco, 341 
Tinea tonsurans 

black- wash, 226 

sulphurous acid, 337 

(See also Skin disease) 
Tonsillitis 

aconite, 20, 79 

capsicum-gargle, 146 

steam, 113 
Tonsils, enlarged 

chromic acid, 68 
Toothache 

atropia, 13 1 

cajuput oil, 137 

creasote, 190 
Trismus nascentium 

chloral, 155 
Trismus 

hemlock, 185 

(See also Tetanus) 



33 



Tympanites 

assafetida, 122 

turpentine, 344 
Typhoid condition 

ammonia, 100 

phosphorus, 282 
Typhoid fever 

alcohol, 87 

ammonia, 102 

calomel, 230 

digitalis, 195 

ergot, 202 

muriatic acid, 163 

opium, 271 

quinia, 172 

salicylate of soda, 367 

turpentine, 344 

veratrum viride, 350 
Typhus 

alcohol, 87 

antimony, 108, ill 

blisters, 145 

chloral, 155 

chlorine- water, 161 

opium, 271 

quinia, 172 



Ulcerated surfaces 

bismuth, 133 

silver nitrate, 1 15 
Ulcers 

acid nitrate of mercury, 225 

carbolic acid, 65 

charcoal poultices, 148 

chromic acid, 68 

copper sulphate, 192 

iodoform, 237 

nitrate of silver, 115 

potassium permanganate, 298 
Uraemic coma 

cathartics, 57 

croton oil, 269 

diaphoretics, 49 

diuretics, 50 

mustard poultices, 330 
Uterine cancer 

iodoform, 237 

(See Cancer) 

Varicose veins 

ergot, 202 
* 



39° 



INDEX OF DISEASES. 



Vesical catarrh 

buchu, 135 

(See Cystitis) 
Vesical irritations 

hyoscyamus, 23 

pareira, 281 
Vesical irritability 

iron, 259 

sodium bicarbonate, 332 

(See Calculus) 
Vomiting 

arsenic, 118 

bismuth, 133 

carbolic acid, 67 

creasote, 190 

hydrocyanic acid, 70 

ice, 113 
Vomiting, persistent 

calomel, 20, 227 

effervescing draught,, 68 

grey powder, 20 

ipecacuanha, 20, 239 

(See also Sarcinous vomiting) 
Vomiting of pregnancy 

bromide of potassium, 303 

ipecacuanha, 238 

oxalate of cerium, 152 

tincture of nux vomica, 261 

Warts 

acetic acid, 63 

chromic acid, 68 

nitric acid, 74 
Whooping-cough 

arsenic, 118 

assafcetida, 122 

belladonna, 127 

bromide of ammonium, 104 

bromide of potassium, 304 

camphor, 140 

chloral, 155 

chloroform, 166 



Whooping-cough — 
cochineal, 180 
cod-liver oil, 263 
ergot, 201 

hydrocyanic acid, 70 
oil of amber, 267 
quinia, 174 
squill, 325 
Winter- cough 
tar, 290 

(See Bronchitis) 
Worms (for general remarks on An- 
thelmintics see page 42) 
Ascaris lumbricoides (RoUnd 
worms) 

azedarach, 355 

oil of wormseed, 153 

santonin, 320 

spigelia, ^33 

turpentine, 345 
Oxyuris vermicularis (Seat 
worms) 

enemata of iron, 207 

enemata of lime-water, 137 

enemata of quassia, 312 

enemata of vinegar, 62 
Taenia (Tape-worms), 42-44 

carbolic acid, 67 

filix mas, 212 

kamala, 363 

koosso, 355 

pumpkin seeds, 281 

rottlera, 363 

turpentine, 345 
Trichina spiralis 

general treatment, 43 
Wrist-drop 
strychnia, 260 
(See Lead-poisoning) 
Wry neck 

hemlock, 185 
(See Myalgia) 



GENERAL INDEX. 



Absinthe, 6 1 

Absinthium, 6 1 

Acacia, 6 1 

Accumulation of digitalis, 199 

of medicines, 24 

of strychnia, 261 
Aceta, 62 
Acetic acid, 62 
Acetum, 62 

destillatum, 62 

lcbelise, 62, 249 

opii, 62, 270 

sanguinarise, 62, 319 

scillae, 62, 325 
Acida, 76 
Acids in biliary derangement, 41 

disadvantages of, 41 

effect on circulation, 39 

effects on secretion, 40 

effects on temperature, 40 

effects on the urine, 41 

external effects, 39 

internal effects, 39 

officinal, 76 

poisonous effects of, 42 

remarks on, 38 

stimulating alkaline secretions, 41 
Acidum aceticum, 62 

aceticum dilutum, 62 

arseniosum, 64, 117 

benzoicum, 132 

carbolicum, 64 

carbolicum impurum, 64 

chromicum, 67 

citricum, 68, 245 

gallicum, 213 

hydrocyanicum dilutum, 69 

lacticum, 73 

muriaticum, 162 

muriaticum dilutum, 162 

nitricum, 73 

nitricum dilutum, 73 

nitro-muriaticum, 75 



Acidum nitro-muriaticum dilutum, 

75 
oxalicum, 75 

phosphoricum dilutum, 285 

phosphoricum glaciale, 285 

salicylicum, 365 

sulphuricum, 338 

sulphuricum aromaticum, 338 

sulphuricum dilutum, 338 

sulphurosum, 337 

tannicum, 213 

tartaricum, 75 

valerianicum, 349 
Acne from bromides, 305 
Aconite, 76 

in fever, 20 

leaves, 76 

root, 77 
Aconitia, 77 
Aconiti folia, 76 

radix, 77 
Aconitum, 76 
Action of antipyretics, 44 

of drugs changed with dose, 21 
Adeps, 80 
Administration, forms of, 17 

of antimony, no 

of opium, 277 

of purgatives, 59 

of quinia, 176 
/Ether, 81 

fortior, 81 
JEthevea., 81 
Alcohol, 84 

amylicum, 91 

dilutum, 84 

fortius, 84 
Alcohol as a food, 90 
Allium, 94 
Allspice, 289 
Almond, 105 

as food in diabetes, 105 

mixture, 105 

(39 1 ) 



39 2 



GENERAL INDEX. 



Aloe, 95 

Barbadensis, 95 

Capensis, 95 

compound, decoction of, 96 

purificata, 95 

Socotrina, 95 
Althaea, 97 
Alum, 97 
Alumen, 97 

exsiccatum, 97 
Aluminii et ammonii sulphas, 97 

et potassii sulphas, 98 

sulphas, 98 
Amber, 267 

American hellebore, 350 
American leeches, 368 
Ammonia, 99 
Ammoniac, 98 
Ammoniacum, 98 
Ammoniated copper, 99 

mercury, 99 
Ammonii benzoas, 99, 132 

bromidum, 99, 134 

carbonas, 99 

chloridum, 99 

chloridum purificatum, 99 

iodidum, 99 

nitras, 99 

sulphas, 99 

valerianas, 99, 349 
Ammonio-ferric alum, 99 
Ammonio-tartrate of iron, 75 
Ammonium benzoate, 132 
Amygdala amara, 105 

dulcis, 105 
Amygdalus, 105 
Amyl nitris, 92 
Amylic alcohol, 91 
Amylum, 105 
Anaesthesia by chloroform, 165 

by ether, 83 

by nitrous oxide gas, 104 
Anaesthetic, local, 65 
Angustura, 106 
Anise, 106 
Anise-seed, 106 
Anisum, 106 
Anthelmintics, 42 

how to give, 19 
Anthemis, 106 
Antidote, acetic acid, 63 

aconite, 77 



Antidote, alcohol, 84 

ammonia, 99 

arsenious acid, 117 

barium, 124 

belladonna, 124 

bitter almond, 105 

bromine, 134 

camphor, 140 

carbolic acid, 64 

chemical, 38 

chloral, 154, 157 

copper, 191 

corrosive poisoning, 105 

corrosive sublimate, 225 

digitalis, 193 

Fowler's solution, 117 

hydrocyanic acid, 69 

iodine, 235 

lead, 291 

lobelia, 249 

muriatic acid, 162 

nitrate of silver, 115 

nitric acid, 74 

opium, 270 

oxalic acid, 75 

phosphorus, 281 

physiological, 38 

physostigma, 285 

potassa, 297 

stramonium, 334 

strychnia, 259 

sulphuric acid, 338 

tartar emetic, 107 

tartaric acid, 76 

tobacco, 340 

veratria, 316 

zinc, 351 
Antidotes, theory of, 37 
Antimonial powder, no 

wine, 107 
Antimonii et potassii tartras, 107 

et potassii tartras, in infantile 
bronchitis, 20 

et potassii tartras, toleration of, 

23 

oxidum, 107 

oxy sulphur etum, 107 

sulphuretum, 107 
Antimonium, 107 

sulphuratum, 107 
Antimony, 1 07 
Antipyretics and refrigerants, 44 



GENERAL INDEX. 



393 



Antiseptic system of Lister, 65 
Antiseptics, action of, 47 

and disinfectants, 45 

properties of charcoal, 147 

solution of chloral as an, 154 
Apiol, 364 
Apomorphia, 280 
Appollinaris water, IT4 
Aqua, in 

acidi carbolici, 64 

acidi carbonici, 253 

ammoniae, 99 

ammoniae fortior, 99 

amygdalae amarae, 105 

anisi, 106 

aurantii florum, 122 

camphorae, 139 

chlormi, 160 

cinnamomi, 180 

creasoti, 190 

destillata, 1 1 1 

foeniculi, 212 

menthae piperita?, 255 

menthae viridis, 255 

rosae, 314 
Aquae, 114 
Araroba, 357 
Areca nut, 356 
Argenti cyanidum, 115 

nitras, 115 

nitras fusa, 115 

oxidum, 115 
Argentum, 115 
Arnica, 116 
Arrowroot, 253 
Arsenic, 117 

constitutional effects of, 120 

in childhood, 27 

in skin disease, toleration of, 24 

white, 117 
Arsenic-eating in Styria, 23, 118 
Arsenicum, 117 
Arsenici iodidum, 117 
Arsenious acid, 64, 117 
Ascaris lumbricoides, 43 
Assafoetida, 121 
Atropia, 124 
Atropiae sulphas, 124 
Aurantii amari cortex, 122 

dulcis cortex, 122 

flores, 122 
Aurantium, 122 



Avenae farina, 123 
Azedarach, 355 

Balsam of Peru, 123 

of Tolu, 123 
Balsamum Peruvianum, 123 

Tolutanum, 123 
Barbadoes aloes, 95 
Barii carbonas, 123 

chloridum, 124 
Bark, cinchona, 170 
Barley, 223 
Bath, nitric acid, 75 
Baths, therapeutic effects of, 1 1 1 
Bay rum, 84 
Bearberry, 347 
Bebeeru bark, 258 
Belae fructus, 356 
Belladonna 124 

effects on animals, 131 

effects on rabbits, ^^ 

in childhood, 27 

leaves, 124 

root, 124 

poisoning, 124 

(See Poisoning in Index of Dis- 
eases) 
Belladonnae foliae, 124 

radix, 124 
Benzoate of ammonium, 99 
Benzoated lard, 132 
Benzoic acid, 132 
Benzoin, 132 
Benzoinum, 132 
Betel nut, 356 

Bichromate of potassium, 302 
Bismuth, 133 

subcarbonate of, 133 

subnitrate of, 133 
Bismuthi subcarbonas, 133 

subnitras, 133 
Bismuthum, 133 
Bitter almond, 105 
Bittersweet, 199 
Blackberry, 315 
Black draught, 328 
Black drop, 270 
Black hellebore, 223 
Black-wash, 225 
Blistering collodion, 143, 220 

papers, 143 
Blisters, caution in use of, 146 



394 



GENERAL INDEX. 



Blisters, therapeutic indications for, 

144 
Blood affected by acids, 39 
Bloodroot, 319 
Bone, 280 
Boneset tea, 204 
Borax, 331 
Brandy, 84 
Bray era, 355 

Bromide of ammonium, 99 
Bromine, 134 
Brominium, 134 
Broom, 326 
Buchu, 135 
Buckthorn, 364 
Burgundy pitch, 284 
Burnett's disinfecting fluid, 351 
Butternut, 242 

Cacao butter, 267 

Cadmii sulphas, 135 

Cadmium, 135 

Caffea, 136 

Caffeine, 136 

Calabar bean, 285 

Calcii carbonas praecipitata, 137 

chloridum, 137 

hypophosphis, 137 

phosphas praecipitata, 137 
Calcis hydras, 137 
Calcium, 137 
Calomel, 224 
Calumba, 138 
Calx, 137 _ 
Calx chlorinata, 137 
Camphor, 139 
Camphora, 139 
Canada fleabane, 204 
Canada pitch, 289 
Canada turpentine, 343 
Canella, 141 
Canna, 141 

Cannabis Americana, 141 
Cannabis Indica, 142 
Cantharides, 143 
Cantharis, 143 
Cape aloes, 95 
Capsicum, 146 
Caraway, 106 
Caraway-seed, 149 
Carbo, 147 

animalis purificatus, 147 



Carbo ligni, 147 
Carbolic acid, 64 

ointment, 64 
Carbon, 147 
Carbonate of ammonium, 99 

of barium, 123 
Carbonated waters, 114 
Cardamom, 149 
Cardamomum, 149 
Carrageen, 169 
Carron oil, 137, 247 
Carum, 149 
Caryophyllus, 149 
Cascarilla, 150 
Cassia fistula, 150 
Cassia Marilandica, 150 
Castillon's powders, 346 
Castor, 150 
Castoreum, 150 
Castor oil, 265 
Cataria, 151 
Catechu, 151 
Catnep, 151 
Catnep-tea, 151 
Caustic, bromine as a, 134 
Caution in regard to chloral, 168 

in regard to chloroform, 168 

in regard to opium in bronchitis, 
274 
Cayenne pepper, 146 
Cera alba, 152 

flava, 152 
Cerata, 150 
Cerate of cantharides, 143 

of extract of cantharides, 143 
Cerates, officinal, 152 
Ceratum cantharidis, 143 

cetacei, 152 

extracti cantharidis, 143 

plumbi subacetatis, 291 

resinae, 312 

resinae compositum, 312 

sabinae, 317 

saponis, 322 

zinci carbonatis, 351 
Cerii oxalas, 152 
Cerium, 152 

oxalate, 152 
Cerum, 152 
Cetaceum, 152 
Cetraria, 153 
Cevadilla, 316 



GENERAL INDEX, 



395 



Chalk, 137, 190 
Chalk-lozenges, 137 
Chalybeate waters, 114 
Chamomile, 106 
Chamomile, German, 254 
Charcoal, purified animal, 147 

wood, 147 
Charta cantharidis, 143 

sinapis, 329 
Chartae, 143 
Chemical antidotes, 38 
Chenopodium, 153 
Cherry-laurel leaves, 363 
Children, how to prescribe for, 26 
Chimaphila, 153 
Chiretta, 154 
Chloral, 154 

caution in bronchitis, 157 

contra-indicated in heart disease, 
156 
Chloral-camphor, 159 
Chloral hydrate, 154 
Chloric ether, 169 
Chloride of ammonium, 99 

of ammonium, purified, 99 

of barium, 124 

of lime, 137 
Chlorine, 160 
Chlorine water, 160 
Chlorinated lime, 137 
Chlorinum, 160 
Chloroform, 163 
Chloroformum, 163 
Chloroformum purificatum, 163 

venale, 163 
Cholagogue, colchicum as a, 181 
Cholagogue purgatives, 58 
Cholagogues, emetics as, 53 
Chondrus, 169 
Chorea, toleration of sulphate of 

zinc in, 24 
Chromic acid, 67 
Cimicifuga, 169 
Cinchona, 170 
Cinchona fiava, 170 

pallida, 170 

rubra, 170 
Cinchona-red, 179 
Cinchonia, 179 
Cinchoniae sulphas, 170 
Cinchonidia, 179 
Cinnamomum, 179 



Cinnamon, 179 

Citrate of iron and ammonium, 99 

Citric acid, 68 

Citrine ointment, 225 

Clarke's rule, doses for children, 28 

Cloves, 149 

Coca, 136 

Coccus, 180 

Cochineal, 180 

Codeia, 279 

Coddiver oil, 262 

when to give, 18 
Coffee, 136 
Colchici radix, 180 

semen, 180 
Colchicum, 180 
Cold affusions, 112 
Cold baths in fever, 112 
Cold cream, 105, 314 
Colic, 130 
Colica pictonum, 97 
Collodion, 220 
Collodium, 220 

Collodium cum cantharide, 143,220 
Collodium flexile, 220 
Collyrium, cadmium sulph. as a, 135 
Colocynth, 182 
Colocynthis, 182 
Columbo, 138 
Combination of drugs, 16 
Compound cathartic pills, 225 
Compound spirit of ether, 81, 91 
Confectio aromatica, 180 

aurantii corticis, 122 

opii, 270 

rosae, 314 

sennae, 328 

sulphuris, 337 
Confectiones, 183 
Confections, officinal, 183 
Confection of orange peel, 122 
Congress-spring water, 114 
Conii folia, 183 

fructus, 183 
Conium, 183 
Constipation, 199 
Constitutional effects from small 

doses, 24 
Copaiba, 186 
Copper, 191 
Coptis, 189 
Coriander, 106, 189 



39 6 



GENERAL INDEX. 



Cornus Florida, 190 

Corrosive sublimate, 225 

Cotton, 220 

Cotton-root bark, 

Cough-medicines, how combined, 1 7 

Counter-irritation, theory of, 47 

Counter-irritants, 47 

Court-plaster, 234 

Cowling's rule, doses for children, 28 

Cranesbill, 218 

Cream of tartar, 297 

Creasote, 190 

Creasotum, 190 

Creta, 190 

Creta praeparata, 137 

Crocus, 190 

Croton-chloral, 159 

Croton oil, 268 

Cryptopia, 279 

Cubeb, 190 

Cubeba, 190 

Culver's root, 245 

Cupri subacetas, 191 

sulphas, 191 
Cuprum, 191 

Cuprum ammoniatum, 99, 191 
Curcuma, 356 
Cusparia, 106 

Daturia, 334 
Decocta, 193 
Decoction of aloes, 96 

of Iceland moss, 153 

of pipsissewa, 153 
Decoctions, officinal, 193 
Decoctum cetrariae, 153 

chimaphilae, 153 

cinchonas flavae, 170 

cinchonas rubras, 1 70 

cornus Floridae, 190 

dulcamaras, 199 

hasmatoxyli, 222 

hordei, 223 

quercus albas, 312 

sarsaparillae compositum, 323 

senegas, 327 

uvas ursi, 347 

Zittmanni, 232 
Deodorized tincture of opium, 270 
Diagnosis between cholera and 
arsenical poisoning, 119 

of opium poisoning, 275 



Dialysed iron, 362 

Diaphoretic effect of antimony, 109 

Diaphoretics, action of, 49 

classes of, 48 
Digitalinum, 193 
Digitalis, 193 

accumulation of, 24 

hints on prescribing, 25 

toleration of, 24 
Dill, 106 
Dilute acetic acid, 62 

alcohol, 84 

hydrocyanic acid, 69 

nitric acid, 73 
Diseases from drinking water, 113 
Disguising taste of drugs, 28 
Disinfectant, chlorine as a, 161 
Disinfectants, antiseptics and, 45 

classes of, 46 

theory of, 46 
Disinfecting by sulphur, 337 
Distilled vinegar, 62 

water, n 1 
Diuretic, copabia as a, 188, 189 

effect of digitalis, 194 
Diuretics, action of, 50 

classes of, 50 

how to aid, 18 
Dogrose, 315 
Dogwood, 190 
Donovan's solution, 117, 225 
Dosage, 19 

Dose, action of drugs altered with, 
21 

constitutional effects from small, 
24 

exceptions to rule, 32 

for children, 26, 28 

general observations upon, 30 

general rule for, 31 

interval between, 21 

of medicines, 19 
Dosing, principles of, 31 
Dover's powder, 237, 270 
Drachma, 30 
Drastic purgatives, 57 
Dried alum, 97 
Dropsy, 200 

Drugs, chemical and physiological 
incompatibilities of, 25 

combination of, 16 

proper time of giving, 1 8 



GENERAL INDEX 



397 



Drysdale, treatment of croup, 302 
Dulcamara, 199 

Earth as a disinfectant, 46 

Ecbolics, action of, 54 

Effect, constitutional or toxic, 24 

Effervescing draughts, 69 

Egg, 280 

Elaterin, 200 

Elaterium, 200 

Elder, 319 

Elixir of cinchona flava, 179 

Emesis by apomorphia (hypoder- 

mically), 280 
Emetia, 241 
Emetic action of copper, 192 

alum as an, 98 

chamomile tea, 106 

mustard as an, 330 
Emetics, action of, 51 

as antidotes, 37 

as cholagogues, 53 

direct, 52 

effects of antimony, 109 

effects on circulation of, 53 

effect on nervous system of, 53 

effects on secretion of, 53 

free perspiration caused by, 54 

indirect, 52 
Emmenagogue, aloes as an, 96 

cotton-root bark, 220 

effect of cimicifuga, 1 70 
Emmenagogues and ecbolics, 54 

direct, 55 

indirect, 55 
Emplastra, 200 
Emplastrum aconiti, 77 

ammoniaci, 63, 98 

ammoniaci cum hydrargyro, 224 

antimonii, 107 

arnicae, 1 16 

assafcetidae, 121 

belladonnae, 124 

ferri, 206 

galbani compositum, 213 

hydrargyri, 224 

opii, 270 

picis Burgundicse, 289 

picis Canadensis, 289 

picis cum cantharide, 143 

plumbi, 291 

resinae, 291, 312 

34 



Emplastrum saponis, 322 
Emulsion of cod-liver oil, 265 
Endermic application of morphia, 

278 
Ergot of rye, 201 
Ergota, 201 
Ergotine, 201 
Ergotism, 203 
Erigeron, 204 

Canadense, 204 
Erysipelas cured by arnica, 116 
Escharotic, alum as an, 97 
Eserina, 288 
Ether, 81 
Ethereal oil, 262 
Ethers, officinal, 81 
Eucalyptus globulus, 356 
Eupatorium, 204 
European worm-seed, 320 
Excoriation, starch for, 105 
Expectorants, action of, 55 

classes of, 55 

emetics as, 53 
Extract of pipsissewa, fluid, 159 
Extracta, 205 
Extracts, officinal, 205 
Extractum aconiti, 77 

arnicae, 116 

belladonnas, 124 

belladonnae alcoholicum, 124 

belladonnae radicis fluidum, 124 

buchu fluidum 135 

calumbae fluidum, 138 

cannabis Americanae, 141 

cannabis Indicae, 142 

chimaphilae fluidum, 153 

cimicifugae fluidum, 169 

cinchonae, 170 

cinchonae fluidum, 170 

colchici aceticum, 63, 180 

colchici radicis fluidum, 180 

colchici seminis fluidum, 181 

colocynthidis, 182 

colocynthidis compositum, 182 

conii, 183 

conii alcoholicum, 183 

conii fructus fluidum, 183 

cornus Floridae fluidum, 190 

cubebae fluidum, 190 

digitalis, 193 

digitalis fluidum, 193 

dulcamara?, 199 



398 



GENERAL INDEX. 



Extractum dulcamaras fluidum. 199 
ergotae fluidum, 63, 201 
erigerontis Canadensis fluidum, 

204 
gelsemii fluidum, 216 
gentianas, 217 
gentianas fluidum, 217 
geranii fluidum, 218 
glycyrrhizas, 219 
glycyrrhizas fluidum, 219 
gossypii radicis fluidum, 220 
haematoxyli, 222 
hellebon, 223 
hydrastis fluidum, 233 
hyoscyami, 233 
hyoscyami alcoholicum, 233 
hyoscyami fluidum, 233 
ignatiae, 234 

ipecacuanhas fluidum, 237 
jalapae, 241 
juglandis, 242 
kramerias, 244 
kramerias fluidum, 244 
lupulinse fluidum, 224 
matico fluidum, 254 
mezerei fluidum, 255 
nucis vomicae, 259 
opii, 270 

pareirse fluidum, 280 
physostigmatis, 285 
pinus Canadensis fluidum, 212 
podophylli, 295 
pruni Virginianae fluidum, 310 
quassiae, 311 
rhei, 313 
rhei fluidum, 313 
rubi fluidum, 315 
sabinae fluidum, 317 
sarsaparillae fluidum, 323 
sarsaparillae fluidum compositum, 

323 
scillae fluidum, 325 

senegas, 327 
senegas fluidum, 127 
sennas fluidum, 328 
serpentarias fluidum, 329 
spigelias fluidum, 333 
spigeliae et sennas fluidum, ^^^ 
stillingias fluidum, 334 
stramonii foliorum, 334 
stramonii seminis, 334 
taraxaci, 342 



Extractum taraxaci fluidum, 342 
uvas ursi fluidum, 347 
Valerianae, 348 
Valerianae fluidum, 348 
veratri viridis fluidum, 350 
zingiberis fluidum, 353 

Farina tritici, 205 

Fel bovinum purification, 356 

Fennel, 106, 212 

Fermentation of food checked by 

acids, 40 
Fermentum, 206 
Ferri chloridum, 206 

citras, 206 

dialysatus, liquor, 362 

et ammonii citras, 99, 206 

et ammonii sulphas, 99, 206 

et ammonii tartras, 75, 99, 206 

et potassii tartras, 206 

et quiniae citras, 206 

et strychniae citras, 206 

ferrocyanidum, 206 

hypophosphis, 206 

lactas, 73, 206 

oxalas, 75, 206 

oxidum hydratum, 206 

phosphas, 206 

pyrophosphas, 68, 206 

subcarbonas, 206 

sulphas, 206 

sulphas exsiccata, 207 

sulphuretum, 206 
Ferrum, 206 

redactum, 207 
Fever, baths in, 112 

diaphoretics in eruptive, 49 

(See Index of Diseases) 
Ficus, 211 
Fig, 211 
Filix mas, 21 1 
Flaxseed, 246 
Fleabane, 200 
Fluidrachma, 30 
Fluiduncia, 30 
Fly-blisters, 143 
Fceniculum, 212 
Fomentations, warm water, 112 
Form of administering drugs, 17 
Fowler's solution, 117 
Foxglove, 193 
Fusel oil, 91 



GENERAL INDEX 



399 



Galbanum, 212 

Gallae, 213 

Gamboge, 214 

Gambogia, 214 

Garlic, 94 

Gastric juice checked by acids, 

40 
Gaultheria, 216 
. Gelsemium, 216 
Gentian, 217 
Gentiana, 217 
Geranium, 218 
German chamomile, 254 
Gettysburg water, 114 
Gin, 84 

Glauber's salt, 331 
Glycerina, 218 
Glycerine, 218 
Glycerita, 219 
Glycerites, officinal, 219 
Glyceritum acidi carbolici, 64 

acidi gallici, 213 

acidi tannici, 213 

picis liquidae, 290 

sodii boratis, 331 
Glycyrrhiza, 219 
Goa-powder, 357 
Goldthread, 189 
Gossypii radicis cortex, 220 
Gossypium, 220 
Goulard's cerate, 139, 291 
Goulard's extract, 291 
Granati fructus cortex, 311 

radicis cortex, 311 
Granum, 30 
Greenhow's, Dr., formula for gouty 

bronchitis, 182 
Green soap, 323 
Gregory's powder, 316 
Griffith's mixture, 206 
Gross, Prof., treatment of chloro- 
form poisoning, 164 
Gruel, oatmeal, 123 
Guaiac, 221 
Guaiaci lignum, 221 

resinse, 221 
Guaiacum, 221 
Guarana, 136 
Gum arabic, 61 
Gun cotton, 220 
Gutta, 30 
Gutta percha, 222 



Habit, 22 

Haematoxylon, 222 

Halford, Dr., ammonia injection 

for snake-bites, 103 
Heart disease(see Index of Diseases) 

caused by tobacco, 341 
croton - chloral contra - indicated 

in, 150 
Heat as a disinfectant, 46 
Hebra, treatment of eczema, 323 
Hedeoma, 223 
Helleborus, 223 
Hemlock, 183 
Hemlock spruce, 289 
Hemorrhage checked by acids, 39 
Hemostatic effects of iron, 307 
Hemp, American, 141 

Indian, 142 
Henbane, 233 
Hiera picra, 95, 141 
Hips, 315 
Hirudo, 368 

Hoffman's anodyne, 81, 9 1 
Honey, 254 
Honeys, officinal, 255 
Hop-pillow, 224 
Hops, 224 
Hordeum, 223 
Horehound, 254 
Horsemint, 256 
Humulus, 224 
Hunyadi Janos water, 114 
Huxham's tincture, 179 
Hydragogue purgatives, 58 
Hydrargyri chloridum corrosivum, 

225 
Hydrargyri chloridum mite, 224 

idiosyncrasy in regard to, 22 
Hydrargyri cyanidum, 225 
Hydrargyri iodidum rubrum, 225 

viride, 225 
Hydrargyri oxidum flavum, 224 

rubrum, 224 
Hydrargyri sulphas flava, 225 

sulphuretum rubrum, 224 
Hydrargyrum, 224 

ammoniatum, 99, 225 
Hydrargyrum cum creta, 20, 137, 

224 
Hydrastis, 233 
Hydrated lime, 137 
oxide of iron, 206 



400 



GENERAL I NDEX, 



Hydrocyanic acid in oil of bitter 

almonds, 105 
Hydrocyanic acid, effects of, on 

chickens, 33 
Hydropathic treatment, 1 12 
Hyoscyami folia, 233 

semen, 233 
Hyoscyamia, 234 
Hyoscyamus, 233 
Hypnotic effect of chloral, 156 
Hypodermic injection of apomor- 
phia, 280 

of atropia and opium, 279 

of morphia, 278 

of strychnia, 262 
Hypophosphite of lime, 137 

Ice for relieving pain, 112 
Iceland moss, 153 
Icthyocolla, 234 
Idiosyncrasy, 22 

in regard to calomel, 22 

in regard to opium, 22 

in regard to quinine, 22 
Ignatia, 234 

Impure carbolic acid, 64 
Impurities of water, 1 13 
Incompatibilities, chemical and 

physiological, 25 
Incompatibility of caustic alkalies 
and alkaloids, 26 

of drugs, 25 

of iodide of potassium and cor- 
rosive sublimate, 26 

of iron and cinchona, 23 

of strychnia and corrosive subli- 
mate, 25 

of sulphuric acid and lead salts, 

Incompatibles with iodine, 236 

Indian bael, 356 

Individual peculiarities, 22 

Infusa, 235 

Infusions, officinal, 235 

Infusum angusturae, 106 

anthemidis, 106 

buchu, 135 

calumbae, 138 

capsici, 146 

caryophylli, 150 

cascarillae, 150 

catechu compositum, 151 



Infusum cinchonae flavae, 170 

cinchonae rubrae, 170 

digitalis, 193 

eupatorii, 204 

gentianae compositum, 217 

humuli, 224 

juniperi, 242 

kramerise, 244 

lini compositum, 247 

pareira, 280 

picis liquidae, 290 

pruni Virginianae, 310 

quassiae, 311 

rhei, 313 

rosae compositum, 314 

salvia, 319 

sennae, 328 

serpentariae, 329 

spigeliae, 333 

tabaci, 340 

taraxaci, 342 

Valerianae, 348 

zingiberis, 353 
Interval between doses, 21 
Intravenous injection of chloral, 155 
Inunction of mercury in congenital 

syphilis, 229, 231 
Iodide of ammonium, 99 

of arsenic, 117 
Iodine, 235 
Iodinium, 235 
Iodism, 307 

to prevent, 17 
Iodoform, 237 
Iodoformum, 237 
Ipecacuanha, 24, 237 
Irish moss, 169 
Iron, 206 

hypophosphite, 206 

sulphide of, 206 
Isinglass, 234 

Jaborandi, 357 

Jalap, 241 

Jalapa, 241 

James's powder, no 

Jervia, 349, 351 

Johnson, Dr. Geo., treatment of 

diarrhoea, 266 
Juglans, 242 
Juices, officinal, 339 
Juniper berries, 242 



GENERAL INDEX. 



401 



Juniperi, 242 

Kamala, 363 
Kermes mineral, 107 
Kinic acid, 178 
Kino, 243 
Kinovin, 179 
Koosso, 355 
Krameria, 244 

Labarraque's solution, 332 
Lactate of iron, 73 
Lactic acid, 73 
Lactophosphate of lime and 

liver oil, 265 
Lactucarium, 244 
Larch bark, 363 
Lard, 80 

Laricis cortex, 363 
Laudanum, 270 

in infancy, 28 
Laughing-gas, 104 
Laurocerasi folia, 363 
Lavandula, 244 
Lavender, 244 
Laxative effects of water, 113 
Laxatives, 57 
Lead, 291 

in drinking-water, 113, 294 

plaster, 291 

water, 291 
Ledoyen's disinfecting solution 
Leeches, 368 
Lemon, 245 

juice, 68 
Leptandra, 245 
Lettuce-opium, 244 
Libra, 30 
Licorice, 219 
Lime, 137 

water, 137 
Limones, 245 
Limonis cortex, 245 

succus, 245 
Lini farina, 246 
Linimenta, 246 
Liniments, officinal, 246 
Linimentum aconiti, 77 

ammonige, 99 

calcis, 137, 247 

camphorae, 139 

cantharidis, 143 



cod- 



291 



34 



Linimentum chloroformi, 163 

plumbi subacetatis, 291 

saponis, 139, 322 

terebinthinae, 343 
Linseed meal, 246 

oil, 246 
Linum, 246 
Liquor ammonii acetatis, 63, 99 

arsenici chloridi, 1 17 

arsenici et hydrargyri iodidi, 117, 
225, 235 

barii chloridum, 124 

calcii chloridi, 137 

calcis, 137 

ferri chloridi, 206 

ferri citratis, 68, 206 

ferri dialysatus, 362 

ferri nitratis, 207 

ferri subsulphatis, 207 

ferri tersulphatis, 207 

gutta-perchae, 163, 222 

hydrargyri nitratis, 225 

iodinii compositus, 235 

magnesiae citratis, 68, 251 

morphiae sulphatis, 270 

plumbi subacetatis, 291 

plumbi subacetatis dilutus, 29 1 

potassae, 296 

potassii arsenitis, 1 17 

potassii citratis, 68, 297 

potassii permanganatis, 297 

sodae, 331 

sodae chlorinatae, 332 

sodii arseniatis, 117, 331 

zinci chloridi, 351 
Liquores, 250 
Liquors, officinal, 250 
Lister's antiseptic system, 65 
Lithii carbonas, 248 

citras, 68, 248 
Lithium, 248 
Lobelia, 249 
Logwood, 222 
Lumbago, hypodermic injections of 

morphia in, 278 
Lupulina, 224 
Lycopodium, 251 

Mace, 257 
Macis, 257 
Magnesia, 251 
Magnesii carbonas, 251 



402 



GENERAL INDEX 



Magnesii sulphas, 251 

Magnesium, 251 

Male fern, 211 

Malt extract, 223 

Manganese, 253 

Manganesii oxidum nigrum, 253 

sulphas, 251 
Manganesium, 253 
Manna, 253 
Maranta, 253 
Marble, 253 
Marjoram, 280 
Marmor, 253 
Marrubium, 254 
Marshmallow, 97 
Marsh-rosemary, 333 
Mastic, 254 
Mastiche, 254 

Materia medica, primary list of, 61 
Matico, 254 
Matricaria, 254 
May-apple, 295 
Measures, domestic, 30 
Meconine, 280 
Mel, 254 

despumatam, 254 

rosae, 314 
Mellita, 255 
Mentha piperita?, 255 

viridis, 255 
Mercurial baths in syphilis, 229, 

231 
Mercurialisation, 230 
Mercury, 224 
Mezereon, 255 
Mezereum, 255 
Milk of almonds, 105 

of ammoniac, 99 

of assafetida, 121 
Mineral waters, 113 
Minimum, 30 
Misturae, 256 
Mistura ammoniaci, 98 

amygdalae, 61, 105 

assafcetidse, 121 

chloroformi, 139, 163 

cretae, 61, 137 

ferri composita, 206 

glycyrrhizse composita, 61, 219 

potassii citratis, 245 
Mixtures, officinal, 256 
Molasses, 318 



Monarda, 256 
Mori succus, 363 
Morphia, 270 
Morphia? acetas, 270 

murias, 270 

sulphas, 270 
Moschus, 256 
Mucilages, officinal, 256 
Mucilagines, 256 
Mucilago acaciae, 61 

sassafras medullar, 324 

tragacanthae, 347 

ulmi, 347 
Mulberry-juice, 363 
Musk, 151,256 
Mustard, 329 

poultice, how to make, 331 
Mydriasis by belladonna, 126 
Mydriatic, hyoscyamus as a, 233 
Myristica, 256 
Myrrh, 257 
Myrrha, 257 

Narceia, 279 

Narcotic effects of alcohol, 85 

Narcotics, when to be given, 19 

Narcotina, 279 

Nectandra, 258 

Neroli water, 122 

Nitrate of ammonium, 99 

Nitric acid, 73 

Nitrite of amyl, 92 

Nitro-muriatic acid, 75 

Nitrous oxide gas, 104 

Norwood's, Dr., tincture of vera- 

trum viride, 350 
Nutgall, 213 
Nutmeg, 256 
Nux vomica, 259 

Oak, 312 

Oat-meal, 123 

Octarius, 30 

Oil of almonds, expressed, 105 

of amber, 267 

of anise, 106 

of bergamot, 132 

of bitter almonds, 105 

of cajuput, 136, 150 

of camphor, 1 39 

of caraway, 149 

of chamomile, 106 



GENERAL INDEX. 



403 



Oil of cloves, 150 

of neroli, 122 

of sweet almonds, 105 

of thyme, 268 

of wormseed, 153 
Oils, officinal, 262 
Ointment, antimony, 107 

belladonna, 124 

benzoin, 132 

cantharides, 143 

carbolic acid, 64 

rose-water, 105 
Ointments, 81 
Olea, 262 
Oleo-resinae, 312 
Oleo-resina capsici, 146 

cubebae, 190 

filicis, 211 

lupulinae, 224 

piperis, 289 

zingiberis, 353 
Oleo-resin of capsicum, 146 
Oleo-resins, officinal, 312 
Oleum aethereum, 262 

amygdalae amarse, 105 

amygdalae expressum, 105 

anisi, 106 

anthemidis, 106 

bergamii, 132 

cajuputi, 136 

camphorae, 139 

cari, 149 

caryophylli, 150 

chenopodii, 153 

cinnamomi, 179 

copaibae, 186 

cubebae, 191 

erigerontis Canadensis, 204 

fceniculi, 212 

gaultheriae, 216 

hedeomae, 223 

juniperi, 242 

lavandulae, 244 

limonis, 245 

lini, 246 

menthae piperitae, 255 

menthae viridis, 255 

monardae, 256 

morrhuae, 262 

myristicae, 256 

olivae, 265 

origani, 280 



Oleum pimentae, 280 

ricini, 265 

rosae, 314 

rosmarini, 315 

rutae, 315 

sabinae, 317 

sassafras, 324 

sesami, 364 

succini, 267 

succini rectificatum, 267 

tabaci, 340 

terebinthinae, 343 

theobromae, 267 

thymi, 268 

tiglii, 268 

Valerianae, 348 
Olive oil, 265 
Opium, 270 

effect on rabbits of, 33 

idiosyncrasy in regard to, 22 

in childhood, 27 
Opodeldoc, 268 
Orange, 122 

flowers, 122 
Orange-peel, bitter, 122 

sweet, 122 
Orgeat syrup, 105 
Origanum, 280 
Os, 280 
Ovum, 280 

Oxalate of cerium, 152 
Oxalic acid, 75 
Oxide of antimony, 107 
Oxymel, 63 

Oxysulphuret of antimony, 107 
Oyster-shell, 346 

prepared, 137 

Pain relieved by counter-irritants, 

Painters' colic, 294 
Papaver, 280 
Papaverina, 279 
Paramorphia, 279 
Paraplegia, alcoholic, 86 
Parasiticides, 47 
Paregoric, 270 
Pareira, 280 
brava, 280 
Parsley, 364 
Partridge -berry, 216 
Pearl-ash, 296 



404 



GENERAL INDEX. 



Peculiarites, individual, 22 

Pennyroyal, American, 223 

Pepo, 281 

Pepper, 289 

Peppermint, 255 

Pepsin, 363 

Pepsina porci, 363 

Perspiration caused by emetics, 54 

Peruvian bark, 170 

Petroselinum, 364 

Phosphorus, 281 

Physiological antidotes, 38 

Physiology of vomiting, 52 

Physostigma, 285 

Pill, Guy's, 232 

Plummer's, 107 
Pills, officinal, 288 
Pilocarpia, 358 
Pilula ferri carbonatis, 207 

saponis composita, 270, 322 
Pilulae, 288 

aloes, 95 

aloes et assafcetidae, 95, 121 

aloes et mastiches, 95 

aloes et myrrhae, 95, 257 

antimonii compositae, 107 

assafcetidae, 121 

catharticae compositae, 225 

copaibae, 186 

ferri compositae, 207 

ferri iodidi, 207, 235 

galbani compositae, 121, 213 

hydrargyri, 224 

opii, 270 

quiniae sulphatis, 1 70 

rhei, 313 

rhei compositae, 95, 313 

scillae compositae, 98, 325 
Pimenta, 289 
Pimento, 150, 289 
Pinkroot, ^33 
Pint, imperial, 30 
Piper, 289 
Piperin, 289 
Pipsissewa, 153 
Pix Burgundica, 289 

Canadensis, 289 

liquida, 290 
Plan of arrangement, 32 
Plaster, warming, 143 
Plasters, officinal, 200 
Plumbi acetas, 291 



Plumbi carbon as, 291 

iodidum, 291 

nitras, 291 
Plumbum, 291 
Podophyllin, 295 
Podophyllum, 295 
Poisoning, 37 (see Index of Dis- 
eases) 

by acids, 42 

by alcohol, 85 

by ammonia, 101, 102 

by amylic alcohol, 91 

by antimony, 199 

by arsenic, 1 17 

by belladonna, 131 

by bitter almonds, 105 

by carbolic acid, 67 

by chloral, 154, 157 

by chloroform, 163 

by copper, 192 

by corrosive sublimate, 225 

by hemlock, 186 

by hydrocyanic acid, 71 

by iodine, 235 

by lead, 292 

by opium, 270, 275 

by phosphorus, 281, 284 

by physostigma, 288 

by santonin, 324 

by strychnia, 259, 261 

by tartar emetic, 107 

by tobacco, 340 

by veratria, 316 

vegetable, 148 
Pomegranate, 311 
Poppy capsules, 280 
Port wine, 84 
Potassa, 296 
Potassa alum, 98 
Potassa cum calce, 137, 296 

with lime, 137 
Potassii acetas, 63, 296 

bicarbonas, 296 

bichromas, 297, 302 

bitartras, 297 

bromidum, 134, 297, 303 
hints on prescribing, 25 

carbonas, 296 

carbonas impura, 296 
pura, 296 

chloras, 297 

citras, 68, 297 



GENERAL INDEX. 



405 



Potassii cyanidum, 297 

et sodii tartras, 297 

ferrocyanidum, 207, 297 

hypophosphis, 297 

iodidum, 297, 305 

iodidum and hydrargyri chlori- 
dum corrosivum, 26 

nitras, 297 

permanganas, 297 

sulphas, 297 
Potassium, 296 
Potassium bromide, 134 

sulphis, 297 

sulphuretum, 297 

tartras, 297 
Poultice, hop, 224 

yeast, 206 
Powders, officinal, 311 
Precipitated carbonate of lime, 137 

phosphate of lime, 137 
Prepared chalk, 137 
Prescribing, rules for, 15 

for children, 26 
Prescription writing, 28 
Prescriptions, how to write, 15, 28 
Proper time for exhibiting drugs, 18 
Prunes, 310 
Prunum, 310 
Prunus Virginians, 310 
Prussian blue, 206 
Pulveres, 311 

effervescentes, 75, 331 

effervescentes aperientes, 75, 332 
Pulvis aloes etcanellae, 95, 141 

aromaticus, 180 

ipecacuanhge comp., 237, 270 

jalapae compositus, 241 

rhei compositus, 313 
Pumpkin-seeds, 281 
Punica granatum, 311 
Purgative, action of, 57 

alum as a, 98 

classes of, 56 

combination of, 59 

for children, 27 

when to be given, 19 
Purging cassia, 150 
Purified aloes, 95 

ox-bile, 357 
Pyroxylon, 220 

Quassia, 311 



Queen's-root, 334 
Quercus alba, 312 

tinctoria, 312 
Questions, 369 
Quicklime, 137 
Quinia, administration of, 177 

idiosyncrasy m regard to, 22 

sulphas, 170 

valerianas, 349 
Quinic acid, 178 
Quinidia, 179 
Quino-tannic acid, 178 

Raisins, 347 

Red saunders, 319 

Refrigerants, antipyretics and, 44 

Remedies, certain classes of, 37 

officinal, 61 . 
Resin, 312 
Resina, 312 

jalapae, 241 

podophylli, 295 

scammonii, 324 
Resinse, 312 
Resins, officinal, 312 
Rhamni succus, 364 
Rhatany, 244 
Rheum, 313 

Rheumatoid arthritis, 222 
Rheumatism, pathology of, 73 
Rhubarb, 313 
Rochelle salt, 297 
Rosa centifolia, 314 

gallica, 314 
Rose, 314 
Rosemary, 315 
Rosmarinus, 315 
Rottlera, 363 
Rubus, 315 
Rue, 315 

Rules for prescribing, 15 
Ruta, 315 

Sabadilla, 316 
Sabina, 317 
Saccharum, 318 

lactis, 318 
Saffron, 190 
Sage, 319 
Sago, 318 
Salicin, 364 
Salicylic acid, 365 



406 



GENERAL INDEX. 



Saline purgatives, 58 

waters, 114 
Salvia, 319 
Sambucus, 319 
Sanguinaria, 319 
Sanguisuga officinalis, 368 
Santalum, 319 
Santonica, 320 
Santonium, 320 
Sapo, 322 

viridis, 323 
Saratoga water, 114 
Sarsaparilla, 323 
Sassafras, 324 

medulla, 324 
Savine, 317 
Scammonium, 324 
Scammony, 324 
Scheele's solution, 72 
Scilla, 325 
Scoparius, 326 
Scrupulum, 30 
Scudamore's mixture, 182 
Secretion altered by acids, 40 
Seidlitz powders, 75, 332 
Seltzer water, 114 
Senega, 327 
Seneka, 327 
Senna, 328 

American, 150 
Serpentaria, 329 
Sevum, 329 
Sherry wine, 84 
Silver, 115 

cyanide of, 115 

fused nitrate of, 115 

in surgery, 115 

nitrate of, 115 

oxide of, 115 

pills of nitrate of, liable to ex- 
plode, 115 

toleration of, 1 16 
Sinapis alba, 329 

nigra, 329 
Skin discoloration from silver salts, 

116 
Slippery-elm, 347 
Snakeroot, 169, 329 
Soap, 322 
Socotrine aloes, 95 
Soda, 331 

mint, 333 



Soda powders, 75, 331 
Sodii acetas, 331 

arsenias, 117, 331 

bicarbonas, 331 

bicarbonas venalis, 331 

boras, 331 

carbonas, 331 

carbonas exsiccata, 332 

chloridum, 331 

hypophosphis, 331 

hyposulphis, 331 

nitras, 331 

phosphas, 332 

sulphas, 331 

sulphis, 331 
Sodium, 331 

arseniate of, 117 
Solution of acetate of ammonium, 

99 
of ammonia, 99 

of arseniate of sodium ,117 

of arsenite of potassium, 117 

of carbolic acid, 64 

of chloride of arsenic, 117 

of chloride of barium, 124 

of chloride of lime, 137 

of iodide of arsenic and mercury, 
117 

of lime, 137 
Spanish-fly, 143 
Spearmint, 255 
Specific action of quinia, 175 
Spermaceti, 152 

cerate, 152 
Spigelia, 333 
Spirit of ammonia, 99 

of ammonia, aromatic, 99 

of camphor, 139 
Spirits, officinal, 91 
Spiritus aethens compositus, 81, 9 1 

aetheris nitrosi, 84, 91 

ammonise, 99 

ammonise aromaticus, 99 

anisi, 106 

camphorae, 139 

chloroform! , 1-63 

cinnamomi, 180 

frumenti, 84, 333 

Geneva?, 84 

juniperi, 243 

juniperi compositus, 243 

lavandulae, 244 



GENERAL INDEX 



407 



Spiritus lavandulas compositus, 244 

limonis, 245 

menthas piperitas, 255 

menthas viridis, 255 

myrciae, 84, 333 

myristicas, 256 

saponatus kalinis, 323 

vini Gallici, 84, 333 
Spurred rye, 201 
Squill, 325 
Starch, 105 

of carina, 141 
Statice, 333 
Stillingia, 334 

Stimulant, ammonia as a, 102 
Stimulants, alcoholic, 85 
Stomach, calomel in irritable, 20 

gray powder in irritable, 20 
Stomach-pump, caution in regard 

to, 37 
Storax, 335 
Stramonium, 334 
Strong alcohol, 84 
Stronger aether, 81 
Strychnia, 259 

eaten by pigeons, 33 

hints on prescribing, 25 

injections, 260 

poisoning, chamomile in, 106 
Strychniae sulphas, 259 
Strychnos ignatia, 234 

nux vomica, 259 
Styrax, 335 

Styria, arsenic-eating in, 23 
Succi, 183, 339 
Succus conii, 183 

taraxaci, 342 
Suet, 329 
Sugar, 318 

of lead, 291 

milk, 318 
Sulphate of aluminium, 98 

of aluminium and ammonium, 97 

of aluminium and potassium, 98 

of ammonium, 99 

ofatropia, 124 

of iron and ammonium, 99 
Sulphur, 335 

baths in skin diseases, 336 

lotum, 335 

praecipitatum, 335 

sublimatum, 335 



Sulphurated antimony, 107 
Sulphuret of antimony, 107 
Sulphuretted waters, 114 
Sulphuric acid, 338 
Sulphuris iodidum, 335 
Sulphurous acid, 337 
Sumbul, 367 
Suppositoria, 267 

acidi carbolici, 64 

acidi tannici, 213 

aloes, 95 

assafcetidae, 121 

belladonnas, 124 

morphias.. 270 

opii, 270 

plumbi, 291 

plumbi et opii, 270, 291 
Suppositories, aloes, 95 

assafcetida, 121 

belladonna, 124 

carbolic acid, 64 

officinal, 267 
Sweet almond, 105 
Sweet spirit of nitre, 84, 91 
Syphilis, 222 
Syrup, orgeat, 105 
Syrupi, 318 
Syrups, officinal, 318 
Syrupus acacias, 61 

acidi citrici, 68, 245 

allii, 63, 94 

amygdalae, 105 

aurantii corticis, 122 
fiorum, 122 

ferri iodidi, 207, 235 

fuscus, 318 

ipecacuanhas, 237 

kramerias, 244 

lactucarii, 244 

limonis, 245 

papaveris, 280 

pruni Virginianas, 310 

rhei, 313 

aromaticus, 313 

rosas Gallicas, 314 

rubi, 315 

sarsaparillae composition, 323 

scillas, 325 

compositus, 107, 325 

senegas, 327 

tolutanus, 123 

zingiberis, 354 



4o8 



GENERAL INDEX. 



Tabacum, 340 
Table-salt, 331 
Taeniae, varieties of, 42 
Tamarind, 342 
Tamarindus, 342 
Tapioca, 342 • 

Tnr, 290 
Taraxacum, 342 
Tartar emetic, 107 
Tartaric acid, 75 

Tartrate of antimony and potas- 
sium, 107 

of iron and ammonia, 99 
Tea, 136 
Teaberry, 216 
Temperature affected by acids, 40 

reduced by baths, 112 
Terebinthina, 343 

Canadensis, 343 
Testa, 346 

praeparata, 137 
Thebaia, 279 
Theobroma, 267 

Therapeutic deductions from physi- 
ological experiments, 33 
Thieves' vinegar, 61 
Thoroughwort, 204 
Tinctura, 346 
Tinctura aconiti radicis, 76 

aloes, 95 

aloes et myrrhse, 95, 257 

arnicae, 116 

assafcetidae, 121 

aurantii, 122 

belladonnas, 124 

benzoini, 132 

benzoini composita, 95, 123, 132 

calumbae, 138 

cannabis, 142 

cantharidis, 143 

capsici, 146 

cardamom i, 149 
composita, 149 

castorei, 150 

catechu, 151 

cinchonas, 170 
composita, 170 

cinnamomi, 180 

colchici, 181 

conii, 183 

cubebae, 191 

digitalis, 193 



Tinctura ferri chloridi, 206 

gallae, 213 

gentianae composita, 217 

guaiaci, 222 

guaiaci ammoniata, 222 

hellebori, 223 

humuli, 224 

hyoscyami, 233 

iodinii, 235 

iodinii composita, 235 

jalapae, 241 

kino, 243 

krameriae, 244 

lobeliae, 249 

lupulinae, 224 

myrrhae, 257 

nucis vomicae, 259 

opii, 270 

opii acetata, 62, 270 

opii camphorata, 139, 270 

opii deodorata, 270 

quassias, 31 1 

rhei, 313 

rhei et sennae, 212, 313 

sangumariae, 319 

scillae, 325 

serpentariae, 329 

stramonii, 334 

tolutana, 123 

Valerianae, 348 

Valerianae ammoniata, 348 

veratri viridis, 350 

zingiberis, 354 
Tinctures, officinal, 346 
Tobacco, 340 
Tolerance of antimony, 109 

of quinia, 172 

of zinc sulphate, 353 
Toleration of drugs, 23 
Tonics, acids as, 41 
Tragacanth, 347 
Tragacantha, 347 
Treatment of belladonna-poisoning, 

124 
Trimethylamine, 368 

hydrochlorate of, 368 
Troches, officinal, 347 
Trochisci, 347 

acidi tannici, 213 

cretae, 137 

cubebae, 191 

ferri subcarbonatis, 206 



GENERAL INDEX 



Trochisci glycyrrhizae et opii, 219, 
270 
ipecacuanhae, 237 
magnesiae, 251 

menthae piperitae, 255 

morphiae et ipecacuanhae, 270 

potassii chloratis, 297 

santonini, 320 

soclii bicarbonatis, 331 

zingiberis, 354 
Turmeric, 356 
Turpentine, 343 
Turpeth mineral, 225 
Typhoid fever propagated by water, 
US 

Ulmus, 347 

Uncia, 30 

Unguenta, 81 

Unguentum acidi carbolici, 64 

acidi tannici, 213 

antimonii, 107 

aquae rosae, 105, 314 

belladonnae, 124 

benzoini, 132 

canthaiidis, 143 

creasoti, 190 

gallae, 213 

hydrargyri, 224 

hydrargyri ammoniati, 225 

hydrargyri iodidi rubri, 225 

hydrargyri nitratis, 225 

hydrargyri oxidi flavae,. 224 

hydrargyri oxidi rubri, 224 

iodinii, 235 

iodinii compositum, 235 

mezerii, 255 

picis liquidae, 290 

plumbi carbonatis, 291 

plumbi iodidi, 291 

potassii iodidi, 297 

stramonii, 334 

sulphuris, 335 

sulphuris iodidi, 335 

tabaci, 340 

veratriae, 316 

zinci oxidi, 351 
Urine, affected by acids, 41 
Uva passa, 347 
Uva ursi, 347 

Valerian, 348 

35 ' 



409 



Valerianate of ammonia, 99 

Valerianic acid, 349 

Vallet's mass, 207 

Vanilla, 349 

Vapor of steam in therapeutics, 

113 . 
Veratralbia, 349 
Veratria, 316 
Veratroidia, 351 
Veratrum album, 349 

viride, 350 
Vienna paste, 137 
Vina, 351 
Vinegar, 62 
Vinum aloes, 95 

antimonii, 107 

colchici radicis, 180 

colchici seminis, 181 

ergotae, 201 

ipecacuanhae, 237 

opii, 270 

Portense, 84 

rhei, 141, 313 

tabaci, 340 

Xericum, 84 
Virginia Sulphur Springs, 1 14 
Vomiting, physiology of, 52 

therapeutics of, 52 

Warm bath in children's com- 
plaints, 112 
Warner's gout cordial, 313 
Water, 1 1 1 

ammonia, 99 

ammonia, stronger, 99 

anise, 106 

bitter almond, 105 

camphor, 139 

orange-flower, 122 
Wax, 152 

white and yellow, 152 
Weights and measures, 29 
Wheat flour, 205 

hellebore, 349 
Whiskey, 84 
Wild cherry, 310 
Wines, officinal, 351 
Wintergreen, 153, 216 
Wistar's cough lozenges, 270 
Wormseed, 153 
Wormwood, 61 
Wrist-drop, 294 



4io 



GENERAL INDEX. 



Yeast, 206 

Yellow jasmine, 216 

Zinc, 351 

Zinci acetas, 63, 351 

carbonas praecipitata, 35 1 
chloridum, 351, 352 
oxidum, 351 



Zinci oxidum venale, 351 

sulphas, 351 

sulphas in chorea, toleration of, 
24 

valerianas, 349, 351 
Zincum, 351 
Zingiber, 353 
Zittmann's decoction, 232 



PARRISH'S PHARMACY— New Edition— Lately Issued. 

A TREATISE ON PHARMACY. Designed as a Text-book for the 
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modifications thus effected, it constitutes, as now presented, a compendium of the 
science and art indispensable to the pharmacist, and of the utmost value to every 
practitioner of medicine desirous of familiarizing himself with the pharmaceutical 
preparation of the articles which he prescribes for his patients. — Chicago Med Journ., 
July, 1S74. 

The work is eminently practical, and has the rare merit of being readable and in- 
teresting, while it preserves a strictly scientific character. The whole work reflects the 
greatest credit on author, editor, and publisher. It will convey some idea of the libe- 
rality which has been bestowed upon its production when we mention that there are 
no less than 280 carefully executed illustrations In conclusion, we heartily recom- 
mend the work, not only to pharmacists, but also to the multitude of medical prac- 
titioners who are obliged to compound their own medicines. It will ever hold an hon- 
ored place on our own book-shelves. — Dublin Mtd. Press and Circular, Aug. 12, 1874. 

Perhaps one, if not the most, important book upon pharmacy, which has appeared 
in the English language, has emanated from the transatlantic press. •' Parrish's 
Pharmacy" is a well-known work on this side of the water, and the fact shows us 
that a really useful work never becomes merely local in its fame. Thanks to the 
judicious editing of Mr. Wiegand, the posthumous edition of ■' Parrish" has been saved 
to the public with all the mature experience of its author, and perhaps none the 
worse for a dash of new blood.— London Pharm. Journ., Oct. 17, 1874. 



GRIFFITH'S UNIVERSAL FORMULARY -New Edition-Lately Issued. 

A UNIVERSAL FORMULARY ; Containing the Methods of Preparing 
and Administering Officinal and other Medicines. The whole 
adapted to Physicians and Pharmaceutists. By Robert E. Grif- 
fith, M.D. , etc. Third Edition, thoroughly Revised, with nume- 
rous additions, by John M. Maisch, Professor of Materia Medica in 
the Phila. College of Pharmacy. In one large and handsome octavo 
volume of about 800 pages : cloth, $4 50; leather, $5 50. 

To the druggist a good formulsry is simply indispensable, and perhaps no formu- 
lary has been more extensively used than the well-known work before us. Many 
physicians have to officiate also as druggists. This is true e?pecially of the country 
physician, and a work which shall teach him the means by which to administer or 
combine his remedies in the most efficacious and pleasant manner, will always hold 
its place upon his shelf. A formulary of this kind is of benefit also to the city phy- 
sician in largest practice. — Cincinnati Clinic, Feb. 21, 1874. 

A more complete formulary than it is in its present form the pharmacist or physi- 
cian could hardly desire. To the first some such work is indispensable, and it is 
hardly less essential to the practitioner who compounds his own medicines. Much of 
what is contained in the introduction ought to be committed to memory by every stu- 
dent of medicine As a help to physicians it will be found invaluable, and doubtless 
will make its way into librai-ies not already supplied with a standard work of the 
kind. — The American Practitioner, Louisville, July, 1874. 

The young practitioner will find the work invaluable in suggesting eligible modes 
of administering many remedies.— Am. Journ, of Pharm., Feb. 1874. 



HENRY C. LEA— Philadelphia. 



STANDARD WQEKS ON OH EMISTBY. 

CHEMISTRY. GENERAL, MEDICAL, AND PHARMACEUTICAL, 
INCLUDING THE CHEMISTRY OF THE U. S. PHARMACO- 
POEIA. A Manual of the General Principles of the Science, and 
their Application to Medicine. By John Attfield, Ph.D., Profes- 
sor of Practical Chemistry to the Pharmaceutical Society of Great 
Britain, etc. Seventh American Edition, Revised from the Sixth 
English Edition, by the author. In one handsome royal 12mo. vol. 
of 668 pp., with S7 illus : cloth, $2 75; leather, $3 25. {Just Issued.) 

A MANUAL OF ELEMENTARY CHEMISTRY; THEORETICAL 
AND PRACTICAL. By George Fownes, Ph.D. A new Ameri- 
can, from the Tenth and revised English Edition. Edited by Robert 
Bridges, M.D. In one large royal 12mo. vol. of about 850 pages, 
with one hundred and ninety-seven illustrations: cloth, $2 75 ; lea- 
ther, $3 25. 

OUTLINES OF ORGANIC CHEMISTRY. By Wohler & Fittio. 
Translated from the Eighth German Edition. By Ira Remsen, M.D., 
Ph.D., Professor of Chemistry in the Johns Hopkins University, 
Baltimore. In one handsome roj'al 12mo. vol. of 550 pages : cloth, 
$300. (Lately Issued . ) 

PRINCIPLES OF THEORETICAL CHEMISTRY, with Special refe- 
rence to the Constitution of Chemical Compounds. By Ira Rem- 
sen, M.D , Ph.D., Professor of Chemistry in the Johns Hopkins 
University, Baltimore. In one royal 12mo. vol. of 232 pages : 
cloth, $1 50. (Now Ready.) 

AN ELEMENTARY TREATISE ON PRACTICAL CHEMISTRY AND 
QUALITATIVE INORGANIC ANALYSIS. Specially adapted for 
Use in the Laboratories of Schools and Colleges, and by Beginners. 
By Frank Clowes, D.Sc. London, Senior Science-Master atthe High 
School, Newcascle-under-Lyme, etc. From the Second and Revised 
English Edition, with about fifty illustrations. In one handsome 
royal 12mo. vol. of 372 pages: cloth, $2 50. (Now Ready.) 

INTRODUCTION TO PRACTICAL CHEMISTRY, INCLUDING AN- 
ALYSIS. By John E. Bowman, M.D. Edited by C. L. Bloxam, 
M.D., Professor of Chemistry in King's College, London. Sixth 
American, from the Sixth and Revised English Edition With nume- 
rous illustrations. In one royal 12mo. vol. of 340 pages : cloth, $2 25. 
(Lately Issued) 

CHEMISTRY, INORGANIC AND ORGANIC. By Charles Loudon 
Bloxam, Professor of Chemistry in King's College, London. From 
the Second London Edition. In one handsome octavo vol. of 700 
pages, with about 300 illus : cloth, $4 ; leather, $5. (Lately Issued.) 

MEDICAL LEXICON; A DICTIONARY OF MEDICAL SCIENCE: 
Containing a Concise Explanation of the various Subjects and Terms 
of Anatomy, Physiology, Pathology, Hygiene, Therapeutics, Phar- 
macology, Pharmacy, Surgery, Obstetrics, Medical Jurisprudence, 
and Dentistry ; Notices of Climate and of Mineral Waters ; Formulas 
for Officinal, Empirical, and Dietetic Preparations; with the Accen- 
tuation and Etymology of the Terms, and the French and other Syn- 
onymes. By Roblev Dunglison, M.D. A New Edition. Thor- 
oughly Revised, and very greatly Modified and Augmented. By 
Richard J. Dunglison, M D. In one very large rnd handsome 
royal octavo volume of 1131 pages: cloth, $6 50; leather, raised 
bands, $7 50. 

HENRY C. LEA— Philadelphia. 



CATALOGUE OF BOOKS 

PUBLISHED BY 

iHiDEJisriFL-sr o. lea. 

(LATE LEA & BLANCHARD.) 



The books in the annexed list will be sent by mail, post-paid, to any 
Post Office in the United States, on receipt of the printed prices. No 
risks of the mail, however, are assumed, either on money or books. Gen- 
tlemen will therefore, in most cases, find it more convenient to deal with 
the nearest bookseller. 

Detailed catalogues furnished or sent free by mail on application. An 
illustrated catalogue of 64 octavo pages, handsomely printed, mailed on 
receipt of 10 cents. Address, 

HENRY C. LEA, 
Nos. 706 and 708 Sansom Street, Philadelphia. 



PERIODICALS, 
Free of Postage. 



AMERICAN JOURNAL OF THE MEDICAL SCIENCES. 1 v 
Edited by Isaac Hays, M.D., published quarterly, about | ^ ° r bve 
1100 large 8vo. pages per annum, !> UolJars per 

MEDICAL NEWS AND LIBRARY, monthly, 384 large I . annum > 
o in advance 

8vo. pages per annum, J 

OR, 

AMERICAN JOURNAL OF THE MEDICAL SCIENCES, 1 
Quarterly, } For six 

MEDICAL NEWS AND LIBRARY, monthly, ' Dollars per 

MONTHLY ABSTRACT OF MEDICAL SCIENCE, 48 [ annum, 

pages per month, or nearly 600 pages per annum. j in advance. 

In all, about 2100 large 8vo. pages per annum, J 

TUTEDICAL NEWS AND LIBRARY, monthly, in advance, $1 00. 

TUTONTHLY ABSTRACT OF MEDICAL SCIENCE, in advance, $2 50. 

OBSTETRICAL JOURNAL. With an American Supplement, edited 
by J. V. Ingham, M. D. $5 00 per annum, in advance. Single 
Numbers, 50 cents. Is published monthly, each number containing 
ninety-six octavo pages. 



HENRY C. LEA'S PUBLICATIONS. 



ASHTON (T. J.) ON THE DISEASES, INJURIES, AND MALFOR- 
MATIONS OF THE RECTUM AND ANUS. With remarks on 
Habitual Constipation. Second American from the fourth London 
edition, with illustrations. 1 vol. 8vo. of about 300 pp. Cloth, $3 25. 

ASHWELL (SAMUEL). A PRACTICAL TREATISE ON THE DIS- 
EASES OF WOMEN. Third American from the third London edi- 
tion. In one 8vo. vol. of 528 pages. Cloth, $3 50. 

ASHHURST (JOHN, Jr.) THE PRINCIPLES AND PRACTICE OF 
SURGERY. FOR THE USE OF STUDENTS AND PRACTI- 
TIONERS. In 1 large 8vo. vol. of over 1000 pages, containing 533 
wood-cuts. Cloth, $6 50; leather, $7 50. 

ATTFIELD (JOHN). CHEMISTRY; GENERAL, MEDICAL, AND 
PHARMACEUTICAL. Seventh edition, revised by the author. In 
1 vol. 12mo. Clcth, $2 75 ; leather, $3 25. 

BROWNE (EDGAR A.) HOW TO USE THE OPHTHALMOSCOPE. 
Elementary instruction in Ophthalmoscopy for the Use of Students. 
In one small 12mo. vol , many illust. Cloth, $1. {Now ready.) 

BLOXAM (C. L.) CHEMISTRY, INORGANIC AND ORGANIC. 
With Experiments. In one handsome octavo volume of 700 pages, 
with 300 illustrations. Cloth, $4 00 ; leather, $5 00. 

BRINTON (WILLIAM). LECTURES ON THE DISEASES OF THE 
STOMACH. From the second London ed. 1 vol. 8vo. Cloth, $3 25. 

BIGELOW (HENRY J) ON DISLOCATION AND FRACTURE OF 
THE HIP, with the Reduction of the Dislocations by the Flexion Me- 
thod. In one 8vo. vol. of 150 pp., with illustrations. Cloth, $2 50. 
BASHAM (W. R.) RENAL DISEASES; A CLINICAL GUIDE TO 
THEIR DIAGNOSIS AND TREATMENT. With illustrations. 
1 vol. 12mo. Cloth, $2 00. 

BTJMSTEAD (F. J.) THE PATHOLOGY AND TREATMENT OF 
VENEREAL DISEASES. Third edition, revised and enlarged, with 
illustrations. 1 vol. 8vo., of over 700 pages. Cloth, $5 ; leather, $6. 
. AND CULLERIER'S ATLAS OF VENEREAL. See"CuLLERiER." 

BARLOW (GEORGE H.) A MANUAL OF THE PRACTICE OF 
MEDICINE. 1 vol. 8vo., of over 600 pages. Cloth, $2 50. 

BAIRD (ROBERT). IMPRESSIONS AND EXPERIENCES OF THE 
WEST INDIES. 1 vol. royal 12mo. Cloth, 75 cents. 
BARNES (ROSERT). A PRACTICAL TREATISE ON THE DIS- 
EASES OF WOMEN. In one handsome 8vo. vol. of about 800 pages, 
with 169 illustrations. Cloth, $5 ; leather, $6. 

BRYANT (THOMAS). THE PRACTICE OF SURGERY. In one 
handsome octavo volume, of over 1000 pages, with many illustra- 
tions. Cloth, $6 25 ; leather, $7 25. 
BRISTOWE (JOHN SYER). A MANUAL OF THE PRACTICE OF 
MEDICINE. A new work, edited with additions by James H. 
Hutchinson, M.D. In one handsome 8vo. volume of over 1100 
pages. Cloth, $5 50; leather, $6 50. {Just issued) 

BOWMAN (JOHN E.) A PRACTICAL HAND-BOOK OF MEDICAL 
CHEMISTRY. Sixth American, from the fourth London edition. 
With numerous illustrations. 1 vol. 12mo. of 350 pp. Cloth, $2 25. 
INTRODUCTION TO PRACTICAL CHEMISTRY, INCLUD- 
ING ANALYSIS. Sixth American, from the sixth London edition, 
with numerous illustrations. 1 vol. 12mo. of 350 pp. Cloth, $2 25. 

BELLAMY'S MANUAL OF SURGICAL ANATOMY. With numerous 
illustrations. In one royal 12mo. vol. Cloth, $2 25. {Lately issued.) 



HENRY C. LEA'S PUBLICATIONS. 



BURNETT (CHARLES H.) THE EAR: ITS ANATOMY, PHYSI- 
OLOGY, AND DISEASES. A Practical Treatise for the Use of 
Students and Practitioners. In one handsome 8vo. vol., with 
many illustrations. (In press.) 

BLANDFORD (Gr. FIELDING). INSANITY AND ITS TREATMENT. 
With an Appendix of the laws in force in the United States on the 
Confinement of the Insane, by Dr. Isaac Ray. In one handsome 8vo 
vol., of 471 pages. Cloth, $3 25. 

CARTER (R. BRUDENELL). A PRACTICAL TREATISE ON DIS- 
EASES OF THE EYE. With additions and test-types, by John 
Green, M.D. In one handsome 8vo. vol. of about 500 pages, with 
124 illustrations. Cloth, $3 75. 

CHAMBERS (T. K.) A MANUAL OF DIET IN HEALTH AND 
DISEASE. In one handsome octavo volume of 310 pages. Cloth, 
$2 75. (Jtist issued.) 

RESTORATIVE MEDICINE. An Harveian Annual Oration 

delivered at the Royal College of Physicians, London, June 21, 1871. 
In one small 12mo. volume. Cloth, $1 00. 

COOPER (B. B.) LECTURES ON THE PRINCIPLES AND PRACTICE 
OF SURGERY. In one large 8vo. vol. of 750 pages. Cloth, $2 00. 

CARPENTER (WM. B.) PRINCIPLES OF HUMAN PHYSIOLOGY. 
From the Eighth English Edition. In one large vol. 8vo., of 1083 
pages. With 373 illustrations. Cloth, $5 50 ; leather, raised bands, 
$6 50. {Just issued ) 

PRIZE ESSAY ON THE USE OF ALCOHOLIC LIQUORS IN 

HEALTH AND DISEASE. New edition, with a Preface by D. F. 
Condie, M.D. 1 vol. 12mo. of 178 pages. Cloth, 60 cents. 

CLELAND (JOHN). A DIRECTORY FOR THE DISSECTION OF 
THE HUMAN BODY. In one small royal 12mo. vol. Cloth, $125. 
(Just issued.) 

CENTURY OF AMERICAN MEDICINE.— A History op Medicine in 
America, 1776-1876. By E. H. Clarke, M.D., Late Prof, of Materia 
Medica in Harvard Univ. ; Henry J. Bigelow, M.D., Prof, of Surgery 
in Harvard Univ. j Samuel D. Gross, M.D., D.C.L. Oxon., Prof, of 
Surgery in Jefferson Med. Coll., Philada. ; T. Gaillard Thomas, 
Prof, of Obstetrics, etc., in Coll. of Phys. and Surgeons, N. Y. ; J. 
S. Billings. M.D., U.S.A., Librarian of National Medical Library, 
Washington. In one handsome royal 12mo. volume of 366 pages. 
Cloth, $2 25. 

0HRISTISON (ROBERT). DISPENSATORY OR COMMENTARY ON 
THE PHARMACOPEIAS OF GREAT BRITAIN AND THE 
UNITED STATES. With a Supplement by R. E. Griffith. In one 
8vo. vol. of over 1000 pages, containing 213 illustrations. Cloth, $4. 

CHURCHILL (FLEETWOOD). ON THE THEORY AND PRACTICE 
OF MIDWIFERY. With notes and additions by D. Francis Condie, 
M.D. With about 200 illustrations. In one handsome 8vo. vol. of 
nearly 700 pages. Cloth, $4; leather, $5. 
ESSAYS ON THE PUERPERAL FEVER, AND OTHER DIS- 
EASES PECULIAR TO WOMEN. In one neat octavo vol. of about 
450 pages. Cloth, $2 50. 

CONDIE (D. FRANCIS). A PRACTICAL TREATISE ON THE DIS- 
EASES OF CHILDREN. Sixth edition, revised and enlarged. In 
one large 8vo. vol. of 800 pages. Cloth, $5 25 ; leather, $6 25. 

CLOWES (FR&NK). AN ELEMENTARY TREATISE ON PRAC 
TICAL CHEMISTRY AND QUALITATIVE INORGANIC ANA- 
LYSIS. Especially adapted for Laboratory Use. From the Second 
English Edition. In one royal 12mo. vol. Cloth, $2 50. (Just 
issued.) 



HENRY C. LEA'S PUBLICATIONS. 



CTJLLERIER (A.) AN ATLAS OF VENEREAL DISEASES. Trans- 
lated and edited by Freeman J. Bumstead, M.D. A large imperial 
quarto volume, with 26 plates containing about 150 figures, beauti- 
fully colored, many of them the size of life. In one vol., strongly 
bound in cloth, $17. 
Same work, in five parts, paper covers, for mailing, $3 per part. 

HYCLOPEDIA OF PRACTICAL MEDICINE. By Dunglison, Forbes, 

^ Tweedie, and Conolly. In four large super-royal octavo volumes, of 

3254 double-columned pages, leather, raised bands, $15. Cloth, $H. 

CAMPBELL'S LIVES OF LORDS KENYON, ELLENBOROUGH, AND 
TENTERDEN. Being the third volume of " Campbell's Lives of 
the Chief Justices of England." In one crown octavo vol. Cloth, $2. 

TjALTON (J. C.) A TREATISE ON HUMAN PHYSIOLOGY. Sixth 
•*-' edition, thoroughly revised, and greatly enlarged and improved, with 

316 illustrations. In one very handsome 8vo. vol. of 830 pp. 

Cloth, $5 50 ; leather, $6 50. {Just issued.) 

DAVIS (F. H.) LECTURES ON CLINICAL MEDICINE. Second 
edition, revised and enlarged. In one 12mo. vol. Cloth, $1 75. 

ON QUIXOTE DE LA MANCHA. Illustrated edition. In two hand- 
some vols, crown 8vo. Cloth, $2 50 ; half morocco, $3 70. 



D 



DEWEES (W. P.) A TREATISE ON THE DISEASES OF FEMALES. 
With illustrations. In one 8vo. vol. of 536 pages. Cloth, $3. 

DRUITT (ROBERT). THE PRINCIPLES AND PRACTICE OF MO 
DERN SURGERY. A revised American, from the eighth London 
edition. Illustrated with 432 wood engravings. In one 8vo. vol. 
of nearly 700 pages. Cloth, $4; leather, $5. 

DUNGLISON (ROBLEY). MEDICAL LEXICON; a Dictionary of 
Medical Science. Containing a concise explanation of the various 
subjects and terms of Anatomy, Physiology, Pathology, Hygiene, 
Therapeutics, Pharmacology, Pharmacy, Surgery, Obstetrics, Medical 
Jurisprudence, and Dentistry. Notices of Climate and of Mineral 
Waters ; Formulae for Officinal, Empirical, and Dietetic Preparations, 
with the accentuation and Etymology of the Terms, and the French 
and other Synonymes. In one very large royal 8vo. vol. New edi- 
tion. Cloth, $6 50; leather, $7 50. (Just issued.) 

HUMAN PHYSIOLOGY. Eighth edition, thoroughly revised. 

In two large 8vo. vols, of about 1500 pp., with 532 illus. Cloth, $7. 

DE LA BECHE'S GEOLOGICAL OBSERVER. In one large 8vo. vol. 
of 700 pages, with 300 illustrations. Cloth, $4. 

DANA (JAMES D.) THE STRUCTURE AND CLASSIFICATION OF 
ZOOPHYTES. With illust. on wood. In one imp. 4to. vol. Cloth, $4. 

ELLIS (BENJAMIN). THE MEDICAL FORMULARY. Being a 
collection of prescriptions derived from the writings and practice of 
the most eminent physicians of America and Europe. Twelfth edi- 
tion, carefully revised by A. H. Smith, M. D. In one 8vo. volume 
of 374 pages. Cloth, $3. 

ERICHSEN (JOHN). THE SCIENCE AND ART OF SURGERY. 
A new and improved American, from the sixth enlarged and re- 
vised London edition. Illustrated with 630 engravings on wood. In 
two large 8vo. vols. Cloth, $9 00; leather, raised bands, $11 00. 

ENCYCLOPAEDIA OF GEOGRAPHY. In three large 8vo. vols. Illus- 
trated with 83 maps and about 1100 wood-cuts. Cloth, $5." 

FOTHERGILL'S PRACTITIONER'S HANDBOOK OF TREATMENT. 
In one handsome 8vo. vol. of about 550 pp. Cloth, $4. (Just issued.) 



HENRY C. LEA'S PUBLICATIONS. 



FARQUHARSON (ROBERT). A GUIDE TO THERAPEUTICS. 
Edited, with additions, embracing the U. S. Pharmacopoeia, by 
Frank Woodbury, M. D. In one neat royal 12mo. volume. Cloth. 
{Nearly ready.} 

FENWICK (SAMUEL). THE STUDENTS' GUIDE TO MEDICAL 
DIAGNOSIS. From the Third Revised and Enlarged London Edi- 
tion. In one vol. royal 12mo. Cloth, $2 25. 

FLETCHER'S NOTES FROM NINEVEH, AND TRAVELS IN MESO- 
POTAMIA, ASSYRIA, AND SYRIA. In one 12mo. vol. Cloth, 75 cts. 

FOX (TILBURY). EPITOME OF SKIN DISEASES, with Formula? 
for Students and Practitioners. In one small 12mo. vol. Cloth, $1. 

FLINT (AUSTIN). A TREATISE ON THE PRINCIPLES AND 
PRACTICE OF MEDICINE. Fourth edition, thoroughly revised 
and enlarged. In one large 8vo. volume of 1070 pages. Cloth, $6 ; 
leather, raised bands, $7. {Just issued.) 
A PRACTICAL TREATISE ON THE PHYSICAL EXPLORA- 
TION OF THE CHEST, AND THE DIAGNOSIS OF DISEASES 
AFFECTING THE RESPIRATORY ORGANS. Second and revised 
edition. One 8vo. vol. of 595 pages. Cloth, $4 50. 
A PRACTICAL TREATISE ON THE DIAGNOSIS AND TREAT 



MENT OF DISEASES OF THE HEART. Second edition, enlarged 
In one neat 8vo. vol. of over 500 pages, $4 00. 

— ON PHTHISIS : ITS MORBID ANATOMY, ETIOLOGY, etc. 
in a series of Clinical Lectures. A new work. In one handsome 8vo. 
volume. Cloth, $3 50. { Just issiied.) 

— A MANUAL OF PERCUSSION AND AUSCULTATION j of the 
Physical Diagnosis of Diseases of the Lungs and Heart, and of Tho- 
racic Aneurism. In one handsome royal 12mo. volume. Cloth, 
$1 75. {Just issued.) 

— MEDICAL ESSAYS. In one neat 12mo. volume. Cloth, $1 38. 



FOWNES (GEORGE). A MANUAL OF ELEMENTARY CHEMISTRY. 
From the tenth enlarged English edition. In one royal 12mo. vol. of 
857 pages, with 197 illustrations. Cloth, $2 75 ; leather, $3 25. 

FULLER (HENRY). ON DISEASES OF THE LUNGS AND AIR 
PASSAGES. Their Pathology, Physical Diagnosis, Symptoms, and 
Treatment. From the second English edition. In one 8vo. vol. 
of about 500 pages. Cloth, $3 50. 

GALLOWAY (ROBERT). A MANUAL OF QUALITATIVE AN- 
ALYSIS. From the fifth Eng. ed. In one 12mo. vol. Cloth, $2 50. 
GLUGE (GOTTLIEB). ATLAS OF PATHOLOGICAL HISTOLOGY. 
Translated by Joseph Leidy, M.D., Professor of Anatomy in the 
University of Pennsylvania, &c. In one vol. imperial quarto, with 
320 copperplate figures, plain and colored. Cloth, $4. 

GREEN (T. HENRY). AN INTRODUCTION TO PATHOLOGY AND 
MORBID ANATOMY. Second Amer., from the third Lond. Ed. 
In one handsome 8vo. vol., with numerous illustrations. Cloth, 
$2 75. {Jtist issued) 

GRAY (HENRY). ANATOMY, DESCRIPTIVE AND SURGICAL. 
A new American, from the fifth and enlarged London edition. In one 
large imperial 8vo. vol. of about 900 pages, with 462 large and elabo- 
rate engravings on wood. Cloth, $6; leather, $7. {Lately issued.) 
GRIFFITH (ROBERT E.) A UNIVERSAL FORMULARY, CON- 
TAINING THE METHODS OF PREPARING AND ADMINISTER- 
ING OFFICINAL AND OTHER MEDICINES. Third and Enlarged 
edition. Edited by John M. Maisch. In one large 8vo vol of 800 
pages, double columns. Cloth, $4 50 ; leather, $5 50. 



HENRY C. LEA'S PUBLICATIONS. 



GB08S (SAMUEL D.) A SYSTEM OF SURGERY, PATHOLOGICAL, 
DIAGNOSTIC, THERAPEUTIC, AND OPERATIVE. Illustrated 
by 1403 engravings. Fifth edition, revised and improved. In two 
large imperial 8vo. vols, of over 2200 pages, strongly bound in 
leather, raised bands, $15. 

PIROSS (SAMUEL D.) A PRACTICAL TREATISE ON THE DIS- 
*-* eases, Injuries, and Malformations of the Urinary Bladder, the Pros- 
tate Gland, and the Urethra. Third Edition, thoroughly Revised 
and Condensed, by Samuel W. Gross, M.D., Surgeon to the Phila- 
delphia Hospital. In one handsome octavo volume, with about two 
hundred illustrations. Cloth, $4 50. (Just issued.) 

A PRACTICAL TREATISE ON FOREIGN BODIES IN THE 

AIR PASSAGES. In one 8vo. vol. of 468 pages. Cloth, $2 75. 

GIBSON'S INSTITUTES AND PRACTICE OF SURGERY. Intwo8vo. 
vols, of about 1000 pages, leather, $6 50. 

GOSSELIN (L ) CLINICAL LECTURES ON SURGERY. Delivered 
at the Hospital of La Charite Translated from the French by Lewis 
A. Stimson, M.D., Surgeon to the Presbyterian Hospital, New York. 
With illustrations. {Publishing in the Medical News and Library 
for 1876-7.) 

HUDSON (A.) LECTURES ON THE STUDY OF FEVER. 1 vol. 
8vo., 316 pages. Cloth, $2 50. 

HEATH (CHRTSTQPHEK). PRACTICAL ANATOMY ; A MANUAL 
OF DISSECTIONS. With addition?, by W. W. Keen, M. D. In 1 
volume; with 247 illustrations. Cloth, $3 50; leather, $4. 

HARTSHORNE (HENRY). ESSENTIALS OF THE PRINCIPLES 
AND PRACTICE OF MEDICINE. Fourth and revised edition. 
Inone 12mo. vol. Cloth, $2 63 ; half bound, $2 88. (Lately issued ) 

CONSPECTUS OF THE MEDICAL SCIENCES. Comprising 

Manuals of Anatomy, Physiology, Chemistry, Materia Medica, Prac- 
tice of Medicine, Surgery, and Obstetrics. Second Edition. In one 
royal 12mo. volume of over 1000 pages, with 477 illustrations. 
Strongly bound in leather, $5 00 ; cloth, $4 25. (Lately issued.) 
A HANDBOOK OF ANATOMY AND PHYSIOLOGY. In one 



neat royal 12mo. volume, with many illustrations. Cloth, $1 75. 

HAMILTON (FRANK H.) A PRACTICAL TREATISE ON FRAC- 
TURES AND DISLOCATIONS. Fifth edition, carefully revised. 
In one handsome 8vo. vol. of 830 pages, with 344 illustrations. Cloth, 
$5 75 ; leather, $6 75. (Just issued.) 

HOLMES (TIMOTHY). SURGERY, ITS PRINCIPLES AND PRAC- 
TICE. In one handsome 8vo. volume of 1000 pages, with 411 illus- 
trations. Cloth, $6; leather, with raised bands, $7. (Just ready.) 

HOBLYN (RICHARD D.) A DICTIONARY OF THE TERMS USED 
IN MEDICINE AND THE COLLATERAL SCIENCES. In one 
12mo. volume, of over 500 double-columned pages. Cloth, $1 50; 
leather, $2. 

HJDGE (HUGH L.) ON DISEASES PECULIAR TO WOMEN, IN- 
CLUDING DISPLACEMENTS OF THE UTERUS. Second and 
revised edition. In one 8vo. volume. Cloth, $4 50. 

THE PRINCIPLES AND PRACTICE OF OBSTETRICS. Illus- 
trated with large lithographic plates containing 159 figures from 
original photographs, and with numerous wood-cuts. In one large 
quarto vol. of 550 double-columned pages. Strongly bound in cloth, 

$14. 



HENRY C. LEA'S PUBLICATIONS. 



HOLLAND (SIR HENRY). MEDICAL NOTES AND REFLECTIONS. 
From the third English edition. In one 8vo. vol. of about 500 pages. 
Cloth, $3 50. 

HODGES (RICHARD M.) PRACTICAL DISSECTIONS. Second edi- 
tion. In one neat royal 12mo. vol., half bound, $2. 

HUGHES. SCRIPTURE GEOGRAPHY AND HISTORY, with 12 
colored maps. In 1 vol. 12mo. Cloth, $1. 

HORNER (WILLIAM E.) SPECIAL ANATOMY AND HISTOLOGY. 
Eighth edition, revised and modified. In two large 8vo. vols, of over 
1000 pages, containing 300 wood-cuts. Cloth, $6. 



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ILL (BERKELEY). SYPHILIS AND LOCAL CONTAGIOUS DIS- 
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HILLIER (THOMAS). HAND-BOOK OF SKIN DISEASES. Second 
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HALL (MRS. M.) LIVES OF THE QUEENS OF ENGLAND BEFORE 
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TONES (C. HANDFIELD). CLINICAL OBSERVATIONS ON FUNC- 
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KIRKES (WILLIAM SENHOUSE). A MANUAL OF PHYSIOLOGY. 
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KNAPP (F.) TECHNOLOGY; OR CHEMISTRY, APPLIED TO THE 
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KENNEDY'S MEMOIRS OF THE LIFE OF WILLIAM WIRT. In 
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LEA (HENRY C.) SUPERSTITION AND FORCE ; ESSAYS ON THE 
WAGER OF LAW, THE WAGER OF BATTLE, THE ORDEAL, 
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STUDIES IN CHURCH HISTORY. The Rise of the Temporal 

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AN HISTORICAL SKETCH OF SACERDOTAL CELIBACY 



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LA ROCHE (R.) YELLOW FEVER. In two 8vo. vols, of nearly 1500 
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PNEUMONIA. In one 8vo. vol. of 500 pages. Cloth, $3. 

LINCOLN (D. F.) ELECTRO-THERAPEUTICS. A Condensed Man- 
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LEISHMAN (WILLIAM). A SYSTEM OF MIDWIFERY. Includ- 
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LAURENCE (J. Z.) AND MOON (ROBERT C.) A HANDY-BOOK 
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8 HENRY C. LEA'S PUBLICATIONS. 

T EHMANN (C. G.) PHYSIOLOGICAL CHEMISTRY. Translated by 
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A MANUAL OF CHEMICAL PHYSIOLOGY. In one very 

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LAWSON (GEORGE). INJURIES OF THE EYE, ORBIT, AND EYE- 
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In one handsome 8vo. vol. Cloth, $3 50. 

LUDLOW (J. L.) A MANUAL OF EXAMINATIONS UPON ANA- 
TOMY, PHYSIOLOGY, SURGERY, PRACTICE OF MEDICINE, 
OBSTETRICS, MATERIA MEDICA, CHEMISTRY, PHARMACY, 
AND THERAPEUTICS. To which is added a Medical Formulary. 
Third edition. In one royal 12mo. vol. of over 800 pages. Cloth, 
$3 25 ; leather, $3 75. 

LYNCH (W. F.) A NARRATIVE OF THE UNITED STATES EX- 
PEDITION TO THE DEAD SEA AND RIVER JORDAN. In one 
large octavo vol., with 28 beautiful plates and two maps. Cloth, $3. 
■ Same "Work, condensed edition. One vol. royal 12mo. Cloth, $1. 

T EE (HENRY) ON SYPHILIS. In one 8vo. vol. Cloth, $2 25. 

LYONS (ROBERT D.) A TREATISE ON FEVER. In one neat 8vo. 
vol. of 362 pages. Cloth, $2 25. 

MARSHALL (JOHN). OUTLINES OF PHYSIOLOGY, HUMAN 
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MACLISE (JOSEPH). SURGICAL ANATOMY. In one large im- 
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MEIGS (CHAS. D ). ON THE NATURE, SIGNS, AND TREATMENT 
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MILLER (JAMES) . PRINCIPLES OF SURGERY. Fourth American, 
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THE PRACTICE OF SURGERY. Fourth American, from the 

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MONTGOMERY (W. F.) AN EXPOSITION OF THE SIGNS AND 
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MULLER (J.) PRINCIPLES OF PHYSICS AND METEOROLOGY. 
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TWTIRABEAU ; A LIFE HISTORY. In one 12mo. vol. Cloth, 75 cts. 

MAGFARLAND'S TURKEY AND ITS DESTINY. In 2 vols, royal 
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MARSH (MRS.) A HISTORY OF THE PROTESTANT REFORMA- 
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NELIGAN(J. MOORE). AN ATLAS OF CUTANEOUS DISEASES. In 
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NEILL (JOHN) AND SMITH (FRANCIS G.) COMPENDIUM OF 
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NIEBUHR (B. G.) LECTURES ON ANCIENT HISTORY; com- 
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ODLING (WILLIAM). A COURSE OF PRACTICAL CHEMISTRY 
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PLAYFAIR (W. S ) A TREATISE ON THE SCIENCE AND PRAC- 
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PAVY (F. W.) A TREATISE ON THE FUNCTION OF DIGESTION, 
ITS DISORDERS AND THEIR TREATMENT. From the second 
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A TREATISE ON FOOD AND DIETETICS, PHYSIOLOGI- 
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PARRISH (EDWARD). A TREATISE ON PHARMACY. With many 
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PIRRIE (WILLIAM) . THE PRINCIPLES AND PRACTICE OF SUR- 
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pEREIRA (JONATHAN). MATERIA MEDIC A AND THERAPEU- 
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PTJLSZKY'S MEMOIRS OF AN HUNGARIAN LADY. In one neat 
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PAGET'S HUNGARY AND TRANSYLVANIA. In two royal 12mo. 
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ROBERTS (WILLIAM). A PRACTICAL TREATISE ON URINARY 
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RAMSBOTHAM (FRANCIS H.) THE PRINCIPLES AND PRAC- 
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EIGBY (EDWARD). A SYSTEM OF MIDWIFERY. Second Ameri- 
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RANKE'S HISTORY OF THE TURKISH AND SPANISH EMPIRES 
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HISTORY OF THE REFORMATION IN GERMANY. Parts I., 

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S CHAFER (EDWARD ALBERT). A COURSE OF PRACTICAL HIS- 
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OMITH (EUSTACE). ON THE WASTING DISEASES OF CHILDREN. 
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SARGENT (F. W.) ON BANDAGING AND OTHER OPERATIONS 
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SMITH (J. LEWIS.) A TREATISE ON THE DISEASES OF IN- 
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SHARPEY (WILLIAM) AND QUAIN (JONES AND RICHARD). 
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SKEY (FREDERIC C.) OPERATIVE SURGERY. In one 8vo. vol. 
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OLADE (D. D.) DIPHTHERIA ; ITS NATURE AND TREATMENT. 
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OMITH (HENRY H.) AND HORNER (WILLIAM E.) ANATOMICAL 
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SMITH (EDWARD). CONSUMPTION ; ITS EARLY AND REME- 
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OTILLE (ALFRED). THERAPEUTICS AND MATERIA MEDICA. 
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STILLE (ALFRED) AND MAISCH (JOHN M.) THE NATIONAL 
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S WAYNE (JOSEPH GRIFFITHS). OBSTETRIC APHORISMS. A 
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STURGES (OCTAVIUS). AN INTRODUCTION TO THE STUDY 
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SCHOEDLER (FREDERICK) AND MEDLOCK (HENRY). WONDERS 
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and Physiology. Translated from the German by H. Medlock. In 
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CjTOKES (W.) LECTURES ON FEVER. In one 8vo. vol. Cloth, $2. 

SMALL BOOKS ON GREAT SUBJECTS. Twelve works ; each one 10 
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STRICKLAND (AGNES). LIVES OF THE QUEENS OF HENRY 
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MEMOIRS OF ELIZABETH, SECOND QUEEN REGNANT OF 

ENGLAND AND IRELAND. In onecrown octavo vol., extra cloth, 
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TANNER (THOMAS HAWKES). A MANUAL OF CLINICAL MEDI- 
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ON THE SIGNS AND DISEASES OF PREGNANCY. From 

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$4 25. 

TUKE (DANIEL HACK). INFLUENCE OF THE MIND UPON THE 
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rpAYLOR (ALFRED S.) MEDICAL JURISPRUDENCE. Seventh 
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PRINCIPLES AND PRACTICE OF MEDICAL JURISPRU- 
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ON POISONS IN RELATION TO MEDICINE AND MEDICAL 



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THOMAS (T. GAILLARD). A PRACTICAL TREATISE ON THE 
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TODD (ROBERT BENTLEY) . CLINICAL LECTURES ON CERTAIN 
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THOMPSON (SIR HENRY). CLINICAL LECTURES ON DISEASES 
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THE DISEASES OF THE PROSTATE, THEIR PATHOLOGY 

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THOMPSON (SIR HENRY). THE PATHOLOGY AND TREATMENT 
OF STRICTURE OF THE URETHRA AND URINARY FISTULA. 
From the third English edition. In one 8vo. vol. of 359 pp., with 
illustrations. Cloth, $3 50. 

WALSHE (W. H.) PRACTICAL TREATISE ON THE DISEASES 
OF THE HEART AND GREAT VESSELS. Third American from 
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WATSON (THOMAS). LECTURES ON THE PRINCIPLES AND 
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WOHLER'S OUTLINES OF ORGANIC CHEMISTRY. Translated 
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12mo. vol. Cloth, $3 00. {Lately issued.) 

WELLS (J. SOELBERG). A TREATISE ON THE DISEASES OF 
THE EYE. Second American, from the Third English edition, with 
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vol., with 6 colored plates and many wood-cuts, also selections from 
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WHAT TO OBSERVE AT THE BEDSIDE AND AFTER DEATH 
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WEST (CHARLES). LECTURES ON THE DISEASES PECULIAR 
TO WOMEN. Third American from the Third English edition. In 
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LECTURES ON THE DISEASES OF INFANCY AND CHILD- 
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ON SOME DISORDERS OF THE NERVOUS SYSTEM IN 

CHILDHOOD. From the London Edition. In one small 12mo. 
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WILLIAMS (CHARLES J. B. and C. T.) PULMONARY CONSUMP- 
TION : ITS NATURE, VARIETIES, AND TREATMENT. In 

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WILSON (ERASMUS). A SYSTEM OF HUMAN ANATOMY. A 
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ON DISEASES OF THE SKIN. The seventh American from 

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Cloth, $5. 

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THE STUDENT'S BOOK OF CUTANEOUS MEDICINE. In 



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WINCKEL ON PATHOLOGY AND TREATMENT OF CHILDBED. 
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ZEISSL ON VENEREAL DISEASES. Translated by Sturgis. 
(Preparing.) 



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